Ingrid Solberg

CLM-2026-9096, UnitedHealthcare, Chemotherapy Infusion, 1st Hour (96413)

In appealWith the payer Denied claims

Billed

$12,842

denied Jun 13

Denial risk

82%

a hard one, worth it

Appeal window

12d

closes Sep 11

Appeals

0

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jun 13
Denied by UnitedHealthcare
Timely Filing (29)
Jun 13
Heron scored it: 82% denial risk
3 factors found, appeal path chosen
Jun 13

The denial

Timely Filing, code 29

Patient: Ingrid Solberg, born 1997-12-26
Payer: UnitedHealthcare
Procedure: Chemotherapy Infusion, 1st Hour (96413)
Diagnosis: C50.911
Denied on: Jun 13, 2026
Assigned to: Heron

Heron says

High recovery risk (82), prioritize this claim in the appeal queue. Timely filing window has lapsed for UnitedHealthcare, 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 it View 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 Ingrid

across every queue

Everything for this patient

Open exposure

$47,744

Recovered

$1,962

5 denied claims5 prior auths4 underpayments4 backlog claims

96417 · Chemotherapy, Additional Sequential

93015 · 3d outstanding

72148 · MRI Lumbar Spine w/o Contrast

96417 · 7d outstanding

70553 · MRI Brain w/ and w/o Contrast

70553 · MRI Brain w/ and w/o Contrast

96413 · Chemotherapy Infusion, 1st Hour

72148 · Medical Necessity

93000 · Medical Necessity

97530 · Medical Necessity

CLM-2026-9096viewing

96413 · Timely Filing

93000 · Pre-Auth Missing

70553 · 99d outstanding

73721 · underpaid 28.5%

96413 · 145d outstanding

96417 · underpaid 14.7%

70553 · underpaid 23.7%

96417 · underpaid 8.7%