Claims / RHP100809

RHP100809

Granite Plains Mutual. Visit on Sep 7, 2026 with Dr. Tomas Varga.

Denied

Charged

$528.00

Contract expects

$259.60

Allowed per fee schedule

Payer allowed

$0.00

Payer paid

$0.00

Patient owes

$0.00

Deductible, coinsurance, copay

At stake

$259.60

What happened

$528.00 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 999020631017.

AppealMore than 30 days

Appeal with the visit note and any supporting records.

Due Mar 27, 2027 (in 172 days; 180 days from the remittance date to appeal)

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
93306 Echocardiogram, complete Refused	$528.00	$259.60	$0.00	$0.00	$0.00	CO-50 Not medically necessary $528.00

Scroll sideways to see every column.

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
Sep 28, 2026	GP99900000631	Denied	Current	$0.00

Scroll sideways to see every column.