Remittance overview

Every payer payment, matched to the claim that was billed and checked against the contract rate. Denials and short payments are explained in plain language, with the date the chance to fix them runs out.

Payments dated Aug 3, 2026 to Sep 28, 2026, as of Oct 7, 2026. Whole organization, every site.

This week: 5 claims worth $2,352 must be appealed or corrected by Oct 14, 2026. 3 claims worth $562 are past their deadline.

Received

$163K

9 payments, 572 claims checked

Recovered

$1.4K

4 claims denied or short paid, then paid at the contract rate

Denial rate

10.0%

$19.2K refused across 57 claims

In the work queue

$23.8K

102 claims need a decision

Awaiting payment

4 with no answer after 30 days

How Recovered is counted: claims whose payment history shows a denial or a short payment, answered by a later payment at the contract rate (an appeal or corrected claim that worked). The amount is what the payer paid beyond its problem answer. A payment the payer reversed and reprocessed on its own is not counted.

Fix these first

Ordered by the date the chance to appeal or correct runs out.

Whole queue

Claim	Next step	Due	Amount
RHP101043 Fernhollow Community Care	Appeal Denied	Past deadline 5 days ago	$202.80
RHP100201 Fernhollow Community Care	Appeal Denied	Past deadline 5 days ago	$187.20
RHP101017 Fernhollow Community Care	Appeal Denied	Past deadline 5 days ago	$171.60
RHP101147 Silver Mesa Senior Advantage	Appeal Denied	Due within 14 days in 4 days	$1,050.00
RHP101121 Silver Mesa Senior Advantage	Appeal Denied	Due within 14 days in 4 days	$720.00
RHP100223 Silver Mesa Senior Advantage	Appeal Denied	Due within 14 days in 4 days	$220.00

Scroll sideways to see every column.

Why money did not arrive

Denials by reason, largest value first.

Denial detail

Prior authorization missing payer reason code 197, 11 claims$6,325.00
After coverage ended payer reason code 27, 5 claims$5,656.60
Not medically necessary payer reason code 50, 9 claims$2,942.60
Another payer may be primary payer reason code 22, 10 claims$1,659.30
Modifier does not fit the code payer reason code 4, 7 claims$819.50
Exact duplicate payer reason code 18, 3 claims$546.96
Missing or invalid information payer reason code 16, 4 claims$428.18

How claims were paid

Each claim counted once, by its latest result.

Underpaid claims are $4,364.97 short of contract. Patients were assigned $20,415.64 in deductibles, coinsurance and copays. Payers added $4.12 in interest and took back $25.35 in earlier overpayments.

Latest payments

All remittances

Paid	Payer	Trace number	Claims	Amount
Sep 28, 2026	Granite Plains Mutual Sep 28, 2026, GP99900000631	GP99900000631	67	$22,241.16
Sep 21, 2026	Tallow Creek Health Plan Sep 21, 2026, EFT9990000498	EFT9990000498	67	$19,074.92
Sep 14, 2026	Fernhollow Community Care Sep 14, 2026, 99900004410	99900004410	57	$12,919.92
Sep 7, 2026	Silver Mesa Senior Advantage Sep 7, 2026, SM9990031177	SM9990031177	68	$15,300.53
Aug 31, 2026	Granite Plains Mutual Aug 31, 2026, GP99900000587	GP99900000587	69	$21,833.51