Claims / RHP100302

RHP100302

Tallow Creek Health Plan. Visit on Aug 9, 2026 with Dr. Priya Raman.

Denied

Charged

$310.00

Contract expects

$167.70

Allowed per fee schedule

Payer allowed

$0.00

Payer paid

$0.00

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$167.70

What happened

$221.00 refused, payer reason code CO-22 (the practice carries it; the patient may not be billed for it): Coordination of benefits: the payer believes another plan should pay first.
$48.00 refused, payer reason code CO-22 (the practice carries it; the patient may not be billed for it): Coordination of benefits: the payer believes another plan should pay first.
$41.00 refused, payer reason code CO-22 (the practice carries it; the patient may not be billed for it): Coordination of benefits: the payer believes another plan should pay first.

Claim number matched exactly. Payer status: Denied. Payer claim number 999010411013.

Bill the correct payerMore than 30 days

Update coverage order with the patient and bill the primary plan.

Due Nov 7, 2026 (in 32 days; 90 days from the date of service to file)

Follow-up

Assigned to Nobody yet

Nobody has recorded a follow-up yet.

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

Service	Charged	Contract	Allowed	Paid	Patient	Adjustments
99213 Established patient visit, low complexity Refused	$221.00	$119.60	$0.00	$0.00	$0.00	CO-22 Another payer may be primary $221.00
90471 Vaccine administration Refused	$41.00	$22.10	$0.00	$0.00	$0.00	CO-22 Another payer may be primary $41.00
90686 Flu vaccine Refused	$48.00	$26.00	$0.00	$0.00	$0.00	CO-22 Another payer may be primary $48.00

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CO-22Another payer may be primaryAnother payer is responsible

Coordination of benefits: the payer believes another plan should pay first.

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

Usual fix: Update coverage order with the patient and bill the primary plan.

Every remittance that answered this claim, oldest first.

Paid	Payment	Result	Status	Paid
Aug 23, 2026	EFT9990000411	Denied	Current	$0.00

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