Claims / RHP100109

RHP100109

Tallow Creek Health Plan. Visit on Aug 7, 2026 with Dr. Samuel Ivers.

OverpaidPayer recovered money

Charged

$312.00

Contract expects

$169.00

Allowed per fee schedule

Payer allowed

$194.35

Payer paid

$194.35

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$25.35

What happened

The payer allowed $194.35, which is $25.35 more than the contract rate of $169.00. Expect the payer to take it back, or refund it.
On Sep 21, 2026 the payer took back $25.35 against this claim on a later payment.

Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999010411009.

No action needed

The payer already took back the overpayment on a later remittance.

Follow-up

Assigned to Nobody yet

Nobody has recorded a follow-up yet.

What was billed, what the contract says, and what the payer did with each service.

Service	Charged	Contract	Allowed	Paid	Patient	Adjustments
99214 Established patient visit, moderate complexity	$312.00	$169.00	$194.35	$194.35	$0.00	CO-45 Above the contracted rate $117.65

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CO-45Above the contracted rateContract rate

The charge is higher than the fee schedule or contracted amount. The difference is written off.

Contractual obligation: The practice absorbs this amount under its contract or the payer rules. It may not be billed to the patient.

Usual fix: Expected. Only a problem if the allowed amount is below your contract rate.

Every remittance that answered this claim, oldest first.

Paid	Payment	Result	Status	Paid
Aug 23, 2026	EFT9990000411	Overpaid	Current	$194.35

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