Ravi Menon

CLM-2025-9092, Aetna, Chemotherapy Infusion, 1st Hour (96413)

RecoveredWith me Denied claims

Billed

$10,662

denied Nov 22

Denial risk

41%

good odds

Appeal window

closed

nothing left to file

Recovered

$10,662

the money is back

What I did

and what comes next

Claim reached Heron
Imported from a CSV export
Nov 22
Denied by Aetna
Missing Information (16)
Nov 22
Heron scored it: 41% denial risk
3 factors found, appeal path chosen
Nov 22
Paid in full
The money is back
Feb 28

The denial

Missing Information, code 16

Patient: Ravi Menon, born 1987-01-14
Payer: Aetna
Procedure: Chemotherapy Infusion, 1st Hour (96413)
Diagnosis: C50.911
Denied on: Nov 22, 2026
Assigned to: Heron

Appeal successful, payment posted

Heron says

Claim rejected for incomplete data, most often a missing referring provider NPI or member ID mismatch. Member ID on file (INS542905) should be revalidated against the payer's eligibility response. Corrected claims for this reason typically pay within 25 days.