RHP101212
Granite Plains Mutual. Visit on Jul 24, 2026 with Dr. Samuel Ivers.
What happened
- $140.00 refused, payer reason code CO-16 (the practice carries it; the patient may not be billed for it): The claim is missing information or has a billing error. A remark code usually says which field.
Claim number matched exactly. Payer status: Denied. Payer claim number 999020544015.
Next step
Read the remark code, fix the field it names, and resubmit.
Due Jan 20, 2027 (in 106 days; 180 days from the date of service to file)
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 |
|---|---|---|---|---|---|---|
| 97110 Therapeutic exercise, 15 minutes Refused | $140.00 | $68.44 | $0.00 | $0.00 | $0.00 |
|
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The codes on this claim, explained
The claim is missing information or has a billing error. A remark code usually says which field.
Contractual obligation: The practice absorbs this amount under its contract or the payer rules. It may not be billed to the patient.
Usual fix: Read the remark code, fix the field it names, and resubmit.
Remark codes: MA130 The claim was incomplete or invalid and has no appeal rights. Submit a new, corrected claim.
Payment history
Every remittance that answered this claim, oldest first.
| Paid | Payment | Result | Status | Paid |
|---|---|---|---|---|
| Aug 17, 2026 | GP99900000544 | Denied | Current | $0.00 |
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As billed
- Date of service
- Jul 24, 2026
- Sent to payer
- Jul 26, 2026
- Provider
- Dr. Samuel Ivers
- Location
- Main CampusMain Campus, East Region
- Patient
- SYN-1212 (synthetic reference)