Demonstration environment. Fictional organization, fictional payers, synthetic data throughout. No patient data. Changes you make stay in this browser only.
ParvinCorpPayer Remittance Bridge

Ridgeline Health Partners. Multi-specialty physician group, 6 sites, 14 providers. This demo covers 12 billing providers, 4 billing locations and 4 contracted payers.

Signed in as

Dana Whitfield, Billing Operations Lead. Imports remittance files, works denials and underpayments, and is the only role that can open a raw remittance file from a payer (835).

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Claims / RHP100117

RHP100117

Granite Plains Mutual. Visit on Aug 13, 2026 with Dr. Alana Reyes.

Denied
Charged
$312.00
Contract expects
$153.40
Allowed per fee schedule
Payer allowed
$0.00
Payer paid
$0.00
Patient owes
$0.00
Deductible, coinsurance, copay
At stake
$153.40

What happened

  • $312.00 refused, payer reason code CO-27 (the practice carries it; the patient may not be billed for it): The service date is after the patient coverage ended.

Claim number matched exactly. Payer status: Denied. Payer claim number 999020587007.

Next step

Bill the correct payerMore than 30 days

Verify eligibility for the service date and bill the plan that covered it. The patient can be billed only when the payer sends it as patient responsibility (group PR).

Due Feb 9, 2027 (in 126 days; 180 days from the date of service to file)

Follow-up

Assigned to Nobody yet

Nobody has recorded a follow-up yet.

Proof (optional)

Line by line

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

ServiceChargedContractAllowedPaidPatientAdjustments
99214 Established patient visit, moderate complexity
Refused
$312.00$153.40$0.00$0.00$0.00
  • CO-27 After coverage ended $312.00

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The codes on this claim, explained

CO-27After coverage endedEligibility

The service date is after the patient coverage ended.

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

Usual fix: Verify eligibility for the service date and bill the plan that covered it. The patient can be billed only when the payer sends it as patient responsibility (group PR).

Payment history

Every remittance that answered this claim, oldest first.

PaidPaymentResultStatusPaid
Aug 31, 2026GP99900000587DeniedCurrent$0.00

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As billed

Date of service
Aug 13, 2026
Sent to payer
Aug 15, 2026
Provider
Dr. Alana Reyes
Location
Eastgate Family CareEastgate Family Care, East Region
Patient
SYN-0117 (synthetic reference)