Claims / RHP100818

RHP100818

Granite Plains Mutual. Visit on Sep 17, 2026 with Dr. Priya Raman.

Paid as expected

Charged

$319.00

Contract expects

$156.94

Allowed per fee schedule

Payer allowed

$156.94

Payer paid

$125.55

Patient owes

$31.39

Deductible, coinsurance, copay

At stake

$0.00

What happened

Allowed at the contract rate. The payer paid $125.55 and $31.39 is the patient share.

Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999020631026.

No action needed

Paid correctly. The patient share goes on the next statement.

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
99214 Established patient visit, moderate complexity	$312.00	$153.40	$153.40	$122.72	$30.68	CO-45 Above the contracted rate $158.60 PR-2 Coinsurance $30.68
36415 Blood draw	$7.00	$3.54	$3.54	$2.83	$0.71	CO-45 Above the contracted rate $3.46 PR-2 Coinsurance $0.71

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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.

PR-2CoinsurancePatient share

The patient percentage share of the allowed amount.

Patient responsibility: The patient owes this amount (deductible, coinsurance, copay or a non-covered service the patient agreed to).

Usual fix: Bill the patient for the coinsurance amount shown.

Every remittance that answered this claim, oldest first.

Paid	Payment	Result	Status	Paid
Sep 29, 2026	GP99900000631	Paid as expected	Current	$125.55

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