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 / RHP100125

RHP100125

Silver Mesa Senior Advantage. Visit on Aug 19, 2026 with Jordan Blake, PA-C.

Denied
Charged
$408.00
Contract expects
$170.00
Allowed per fee schedule
Payer allowed
$0.00
Payer paid
$0.00
Patient owes
$0.00
Deductible, coinsurance, copay
At stake
$170.00

This will repeat: Jordan Blake, PA-C is not recognized by Silver Mesa Senior Advantage.

Until the enrollment is fixed, every claim Jordan Blake, PA-C sends Silver Mesa Senior Advantage is likely to be refused the same way. 3 other claims are still out, with $893.00 charged:

  • RHP100221 visit Jul 30, 2026, $353.00 charged, already in the work queue
  • RHP100251 visit Aug 27, 2026, $312.00 charged, awaiting payment
  • RHP100252 visit Sep 20, 2026, $228.00 charged, awaiting payment

Check this provider's enrollment with Silver Mesa Senior Advantage in Credential Tracker, then send corrected claims once it is effective.

What happened

  • $408.00 refused, payer reason code CO-185 (the practice carries it; the patient may not be billed for it): The rendering provider is not eligible to perform the service billed.

Claim number matched exactly. Payer status: Denied. Payer claim number 999031177005.

Next step

AppealMore than 30 days

Check the provider enrollment with this payer. A credentialing gap is the usual cause.

Due Nov 6, 2026 (in 31 days; 60 days from the remittance date to appeal)

Print appeal summary

Follow-up Open

Assigned to Kendra Hollis

Appeal. Provider enrollment with Silver Mesa was still pending on the date of service. Asked credentialing for the effective date. Dana Whitfield, Sep 30, 2026Link (provider.silvermesa.example)
Proof (optional)

Line by line

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

ServiceChargedContractAllowedPaidPatientAdjustments
99204 New patient visit, moderate complexity
Refused
$408.00$170.00$0.00$0.00$0.00
  • CO-185 Rendering provider not eligible $408.00

Scroll sideways to see every column.

The codes on this claim, explained

CO-185Rendering provider not eligibleProvider not eligible

The rendering provider is not eligible to perform the service billed.

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

Usual fix: Check the provider enrollment with this payer. A credentialing gap is the usual cause.

Remark codes: N290 The rendering provider identifier was missing or invalid.

Payment history

Every remittance that answered this claim, oldest first.

PaidPaymentResultStatusPaid
Sep 7, 2026SM9990031177DeniedCurrent$0.00

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As billed

Date of service
Aug 19, 2026
Sent to payer
Aug 21, 2026
Provider
Jordan Blake, PA-C
Location
StonebridgeStonebridge, West Region
Patient
SYN-0125 (synthetic reference)