Heron

Uma Krishnan

CLM-2026-9087, BCBS, MRI Lumbar Spine w/o Contrast (72148)

In reviewWith you Denied claims
Billed
$3,988
denied Jul 2
Denial risk
83%
a hard one, worth it
Appeal window
31d
closes Sep 30
Appeals
0
none filed yet

What I did

and what comes next
  1. Claim reached Heron
    Posted from the 835 remittance
    Jul 2
  2. Denied by BCBS
    Timely Filing (29)
    Jul 2
  3. Heron
    Heron scored it: 83% denial risk
    3 factors found, appeal path chosen
    Jul 2
  4. Appeal window closes
    31 days left to file
    Sep 30

The denial

Timely Filing, code 29

Patient
Uma Krishnan, born 1977-08-21
Payer
BCBS
Procedure
MRI Lumbar Spine w/o Contrast (72148)
Diagnosis
M51.16
Denied on
Jul 2, 2026
Assigned to
Heron
Heron says
High recovery risk (83), prioritize this claim in the appeal queue. Timely filing window has lapsed for BCBS, appeal requires proof of original submission. Check clearinghouse acknowledgment records for the original 837 transmission date.

No appeal yet

I can draft one from this claim's history

Draft itView the claim form

Open Intelligence, pick this claim, and I write the letter from the denial, the payer's rules and the clinical guideline. You sign it here.

What I sent

  • Proof of timely filing

Everything I know about Uma

across every queue
Everything for this patient
Open exposure
$16,108
Recovered
$1,901
2 denied claims2 prior auths2 underpayments2 backlog claims
CLM-2026-5142
72148 · 3d outstanding
$4,775
Pending payer
Aug 27
AUTH-4008
73721 · MRI Lower Extremity Joint
75% odds
Pending
Aug 11
AUTH-4032
70553 · MRI Brain w/ and w/o Contrast
74% odds
Approved
Aug 10
CLM-2026-9087viewing
72148 · Timely Filing
$3,988
In review
Jul 2
CLM-2026-5021
70553 · 64d outstanding
$3,996
Awaiting info
Jun 27
CLM-2026-7003
73721 · underpaid 19.7%
$772 short
Recovered
Feb 11
CLM-2025-9069
72148 · Medical Necessity
$3,349
In appeal
Dec 10
CLM-2025-7095
72148 · underpaid 22.1%
$1,129 short
Recovered
Nov 30