RHP101043
Fernhollow Community Care. Visit on Jul 16, 2026 with Jordan Blake, PA-C.
What happened
- $624.00 refused, payer reason code CO-197 (the practice carries it; the patient may not be billed for it): Authorization or notification was required and not on file.
Claim number matched exactly. Payer status: Denied. Payer claim number 999044301046.
Next step
If authorization was obtained, appeal with the number. If not, write off; it cannot be billed to the patient.
Due Oct 3, 2026 (4 days ago; 60 days from the remittance date to appeal)
Assigned to Nobody yet
Nobody has recorded a follow-up yet.
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 |
|---|---|---|---|---|---|---|
| 73721 MRI of a leg joint Refused | $624.00 | $202.80 | $0.00 | $0.00 | $0.00 |
|
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The codes on this claim, explained
Authorization or notification was required and not on file.
Contractual obligation: The practice absorbs this amount under its contract or the payer rules. It may not be billed to the patient.
Usual fix: If authorization was obtained, appeal with the number. If not, write off; it cannot be billed to the patient.
Payment history
Every remittance that answered this claim, oldest first.
| Paid | Payment | Result | Status | Paid |
|---|---|---|---|---|
| Aug 4, 2026 | 99900004301 | Denied | Current | $0.00 |
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As billed
- Date of service
- Jul 16, 2026
- Sent to payer
- Jul 18, 2026
- Provider
- Jordan Blake, PA-C
- Location
- Eastgate Family CareEastgate Family Care, East Region
- Patient
- SYN-1043 (synthetic reference)