RHP100119
Granite Plains Mutual. Visit on Aug 15, 2026 with Dr. Helen Park.
What happened
- $140.00 refused, payer reason code CO-96 (the practice carries it; the patient may not be billed for it): The service is not covered. A remark code usually says why.
Claim number matched exactly. Payer status: Denied. Payer claim number 999020587009.
Next step
Contractual obligation (group CO): the payer assigned this amount to the practice, so it may not be billed to the patient; doing so is balance billing. The service is not covered. A remark code usually says why. Write it off. If the patient signed a waiver before the visit, send a corrected claim with the waiver modifier (for Medicare, GA) so the payer can reassign it to the patient; if the service was necessary, appeal instead.
Assigned to Nobody yet
Nobody has recorded a follow-up yet.
Line by line
What was billed, what the contract says, and what the payer did with each service.
| Service | Charged | Contract | Allowed | Paid | Patient | Adjustments |
|---|---|---|---|---|---|---|
| 97110 Therapeutic exercise, 15 minutes Refused | $140.00 | $68.44 | $0.00 | $0.00 | $0.00 |
|
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The codes on this claim, explained
The service is not covered. A remark code usually says why.
Contractual obligation: The practice absorbs this amount under its contract or the payer rules. It may not be billed to the patient.
Usual fix: Bill the patient only if they signed a waiver or the plan allows it; otherwise write off.
Remark codes: N130 Check the plan benefit documents for restrictions on this service.
Payment history
Every remittance that answered this claim, oldest first.
| Paid | Payment | Result | Status | Paid |
|---|---|---|---|---|
| Aug 31, 2026 | GP99900000587 | Denied | Current | $0.00 |
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As billed
- Date of service
- Aug 15, 2026
- Sent to payer
- Aug 17, 2026
- Provider
- Dr. Helen Park
- Location
- Riverside OrthopedicsRiverside Orthopedics, West Region
- Patient
- SYN-0119 (synthetic reference)