Isabel Carvalho

CLM-2026-9076, UnitedHealthcare, Chest X-Ray, 2 Views (71046)

DeniedWith me Denied claims

Billed

$1,413

denied Aug 7

Denial risk

70%

winnable with the right notes

Appeal window

67d

closes Nov 5

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Aug 7
Denied by UnitedHealthcare
Medical Necessity (50)
Aug 7
Heron scored it: 70% denial risk
3 factors found, appeal path chosen
Aug 7
Appeal window closes
67 days left to file
Nov 5

The denial

Medical Necessity, code 50

Patient: Isabel Carvalho, born 1989-06-08
Payer: UnitedHealthcare
Procedure: Chest X-Ray, 2 Views (71046)
Diagnosis: R05.9
Denied on: Aug 7, 2026
Assigned to: Heron

Heron says

UnitedHealthcare denies 48% of 71046 claims without documented conservative treatment. Clinical notes supporting medical necessity were not attached to the original submission. Attach treatment history and imaging before appealing, overturn rate rises sharply with documentation.