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 / RHP100453

RHP100453

Granite Plains Mutual. Visit on Aug 2, 2026 with Dr. Martin Osei.

Underpaid
Charged
$3,480.00
Contract expects
$1,711.00
Allowed per fee schedule
Payer allowed
$1,557.01
Payer paid
$1,557.01
Patient owes
$0.00
Deductible, coinsurance, copay
At stake
$153.99

What happened

  • The payer allowed $1557.01 against a contract rate of $1711.00: $153.99 short.

Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999020587063.

Next step

AppealMore than 30 days

Dispute the shortfall against the contracted rate. Attach the fee schedule page.

Due Feb 27, 2027 (in 144 days; 180 days from the remittance date to appeal)

Print appeal summary

Follow-up

Assigned to Nobody yet

Nobody has recorded a follow-up yet.

Proof (optional)

Line by line

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

ServiceChargedContractAllowedPaidPatientAdjustments
27447 Total knee replacement$3,480.00$1,711.00$1,557.01$1,557.01$0.00
  • CO-45 Above the contracted rate $1,922.99

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The codes on this claim, explained

CO-45Above the contracted rateContract rate

The charge is higher than the fee schedule or contracted amount. The difference is written off.

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

Usual fix: Expected. Only a problem if the allowed amount is below your contract rate.

Payment history

Every remittance that answered this claim, oldest first.

PaidPaymentResultStatusPaid
Aug 31, 2026GP99900000587UnderpaidCurrent$1,557.01

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As billed

Date of service
Aug 2, 2026
Sent to payer
Aug 4, 2026
Provider
Dr. Martin Osei
Location
Riverside OrthopedicsRiverside Orthopedics, West Region
Patient
SYN-0453 (synthetic reference)