Desmond Achebe

CLM-2026-9097, UnitedHealthcare, Therapeutic Activities, 15 min (97530)

RecoveredWith me Denied claims

Billed

$1,114

denied Feb 28

Denial risk

35%

good odds

Appeal window

closed

nothing left to file

Recovered

$1,114

the money is back

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Feb 28
Denied by UnitedHealthcare
Missing Information (16)
Feb 28
Heron scored it: 35% denial risk
3 factors found, appeal path chosen
Feb 28
Paid in full
The money is back
Apr 14

The denial

Missing Information, code 16

Patient: Desmond Achebe, born 1993-04-13
Payer: UnitedHealthcare
Procedure: Therapeutic Activities, 15 min (97530)
Diagnosis: M62.81
Denied on: Feb 28, 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 (INS897079) should be revalidated against the payer's eligibility response. Corrected claims for this reason typically pay within 21 days.