Claims / RHP101225

RHP101225

Granite Plains Mutual. Visit on Jul 29, 2026 with Dr. Nina Castellano.

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 999020544028.

AppealMore than 30 days

Appeal with the visit note and any supporting records.

Due Feb 13, 2027 (in 130 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

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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
Aug 17, 2026	GP99900000544	Denied	Current	$0.00

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