Claims / RHP100221

RHP100221

Silver Mesa Senior Advantage. Visit on Jul 30, 2026 with Jordan Blake, PA-C.

Denied

Charged

$353.00

Contract expects

$147.00

Allowed per fee schedule

Payer allowed

$0.00

Payer paid

$0.00

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$147.00

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 $948.00 charged:

RHP100125 visit Aug 19, 2026, $408.00 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

$312.00 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.
$41.00 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 999031102001.

Next step

AppealDue within 14 days

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

Due Oct 11, 2026 (in 5 days; 60 days from the remittance date to appeal)

Print appeal summary

Follow-up In progress

Assigned to Dana Whitfield

Appeal. Same enrollment gap as RHP100125. Waiting on the Silver Mesa effective date before appealing. Dana Whitfield, Oct 3, 2026

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
99214 Established patient visit, moderate complexity Refused	$312.00	$130.00	$0.00	$0.00	$0.00	CO-185 Rendering provider not eligible $312.00
93000 Electrocardiogram Refused	$41.00	$17.00	$0.00	$0.00	$0.00	CO-185 Rendering provider not eligible $41.00

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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.

Paid	Payment	Result	Status	Paid
Aug 12, 2026	SM9990031102	Denied	Current	$0.00

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As billed

Payer: Silver Mesa Senior Advantage
Date of service: Jul 30, 2026
Sent to payer: Aug 1, 2026
Provider: Jordan Blake, PA-C
Location: StonebridgeStonebridge, West Region
Patient: SYN-0221 (synthetic reference)