Claims / RHP100201

RHP100201

Fernhollow Community Care. Visit on Jul 19, 2026 with Dr. Owen Whitaker.

Denied

Charged

$576.00

Contract expects

$187.20

Allowed per fee schedule

Payer allowed

$0.00

Payer paid

$0.00

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$187.20

What happened

$576.00 refused, payer reason code CO-50 (the practice carries it; the patient may not be billed for it): The payer decided the service was not medically necessary.

Claim number matched exactly. Payer status: Denied. Payer claim number 999044301001.

AppealPast deadline

Appeal with the visit note and any supporting records.

Due Oct 3, 2026 (4 days ago; 60 days from the remittance date to appeal)

Follow-up Open

Assigned to Kendra Hollis

Appeal. Pulled the visit note and imaging report. Appeal letter not sent yet. Dana Whitfield, Sep 27, 2026

Earlier follow-ups

Appeal, open. Denied as not medically necessary. Requested the visit note from the clinic. Not assigned. Dana Whitfield, Sep 21, 2026

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

Service	Charged	Contract	Allowed	Paid	Patient	Adjustments
64483 Epidural steroid injection, lumbar Refused	$576.00	$187.20	$0.00	$0.00	$0.00	CO-50 Not medically necessary $576.00

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CO-50Not medically necessaryMedical necessity

The payer decided the service was not medically necessary.

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

Usual fix: Appeal with the visit note and any supporting records.

Remark codes: N130 Check the plan benefit documents for restrictions on this service.

Every remittance that answered this claim, oldest first.

Paid	Payment	Result	Status	Paid
Aug 4, 2026	99900004301	Denied	Current	$0.00

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