Jonah Weiss

CLM-2026-9071, Cigna, Therapeutic Activities, 15 min (97530)

In appealWith the payer Denied claims

Billed

$2,949

denied Jan 26

Denial risk

64%

winnable with the right notes

Appeal window

lapsed

closes Apr 26

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jan 26
Denied by Cigna
Not Covered (96)
Jan 26
Heron scored it: 64% denial risk
3 factors found, appeal path chosen
Jan 26

The denial

Not Covered, code 96

Patient: Jonah Weiss, born 2005-05-15
Payer: Cigna
Procedure: Therapeutic Activities, 15 min (97530)
Diagnosis: M62.81
Denied on: Jan 26, 2026
Assigned to: Heron

Heron says

Service is excluded under the member's current Cigna benefit plan. Verify benefits as of the date of service, plan may have changed mid-year. If non-covered is confirmed, route to patient responsibility rather than appeal.

No appeal yet

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Draft it View the claim form

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What I sent

Nothing sent yet.

Everything I know about Jonah

across every queue

Everything for this patient

Open exposure

$55,849

Recovered

$2,485

4 denied claims3 prior auths3 underpayments6 backlog claims

AUTH-4037

96417 · Chemotherapy, Additional Sequential

71046 · 3d outstanding

96417 · 3d outstanding

96417 · 4d outstanding

96415 · Chemotherapy Infusion, Addl Hour

96415 · 15d outstanding

96417 · underpaid 11.1%

97140 · Pre-Auth Missing

96417 · Medical Necessity

96413 · Chemotherapy Infusion, 1st Hour

97110 · 44d outstanding

96417 · Medical Necessity

96413 · 89d outstanding

96413 · underpaid 25.9%

93306 · underpaid 14.1%

$76 short

Written off

Oct 3