RHP101253
Granite Plains Mutual. Visit on Jul 19, 2026 with Dr. Tomas Varga.
What happened
- The payer allowed $1557.01 against a contract rate of $1711.00: $153.99 short.
Claim number matched exactly. Payer status: Processed as primary. Payer claim number 999020544056.
Next step
Dispute the shortfall against the contracted rate. Attach the fee schedule page.
Due Feb 13, 2027 (in 130 days; 180 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 |
|---|---|---|---|---|---|---|
| 27447 Total knee replacement | $3,480.00 | $1,711.00 | $1,557.01 | $1,557.01 | $0.00 |
|
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The codes on this claim, explained
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.
Payment history
Every remittance that answered this claim, oldest first.
| Paid | Payment | Result | Status | Paid |
|---|---|---|---|---|
| Aug 17, 2026 | GP99900000544 | Underpaid | Current | $1,557.01 |
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As billed
- Date of service
- Jul 19, 2026
- Sent to payer
- Jul 21, 2026
- Provider
- Dr. Tomas Varga
- Location
- Riverside OrthopedicsRiverside Orthopedics, West Region
- Patient
- SYN-1253 (synthetic reference)