Denials & Appeals
Workspace for complex post-adjudication denials requiring clinical evidence and structured appeals.
Open Denials
67
Appeals Drafted
22
Under Review
9
Appeals Submitted
18
Appeals Won
12
Revenue Recovered
$46,800
Denial queue
| Claim | Payer | Code | Reason | Amount | Appeal deadline | Clinical review | Appeal status | Action |
|---|---|---|---|---|---|---|---|---|
| CLM-20700 | Summit Blue | 50 | Medical necessity | $6,207 | 2025-08-22 | In Review | Drafted | |
| CLM-20701 | National Benefit Partners | M127 | Missing documentation | $7,664 | 2025-10-11 | In Review | Under Review | |
| CLM-20702 | Summit Blue | 96 | Non-covered service | $2,320 | 2025-09-19 | Approved | Under Review | |
| CLM-20703 | Summit Blue | 197 | Prior authorization issue | $4,974 | 2025-09-08 | Pending | Not Started | |
| CLM-20704 | Summit Blue | 11 | Coding mismatch | $3,569 | 2025-10-16 | Pending | Submitted | |
| CLM-20705 | MetroChoice Health | 18 | Duplicate claim | $3,367 | 2025-11-18 | Approved | Submitted | |
| CLM-20706 | National Benefit Partners | 50 | Medical necessity | $2,264 | 2025-09-19 | Pending | Under Review | |
| CLM-20707 | Summit Blue | M127 | Missing documentation | $3,610 | 2025-11-25 | In Review | Not Started | |
| CLM-20708 | Summit Blue | 96 | Non-covered service | $1,664 | 2025-09-07 | Pending | Not Started | |
| CLM-20709 | UnityCare Insurance | 197 | Prior authorization issue | $3,414 | 2025-10-08 | Approved | Submitted | |
| CLM-20710 | National Benefit Partners | 11 | Coding mismatch | $3,887 | 2025-08-25 | Approved | Under Review | |
| CLM-20711 | UnityCare Insurance | 18 | Duplicate claim | $6,268 | 2025-11-06 | In Review | Submitted | |
| CLM-20712 | MetroChoice Health | 50 | Medical necessity | $6,269 | 2025-11-22 | Approved | Submitted | |
| CLM-20713 | MetroChoice Health | M127 | Missing documentation | $6,055 | 2025-11-18 | Approved | Under Review |