Payers / Granite Plains Mutual
Granite Plains Mutual
Commercial. Payer ID 99902. Appeals within 180 days of the remittance; claims within 180 days of the visit.
Payments dated Aug 17, 2026 to Sep 28, 2026, as of Oct 6, 2026. Whole organization, every site.
Received
$66,971.11
3 payments
Denial rate
9.7%
19 of 196 claims
Underpaid
$4,283.07
Below the contract rate
Days to pay
18
Average, sent to paid
Open work (58)
| Claim | Result | At stake |
|---|---|---|
| LEGACY-55120 | Unmatched | $108.56 |
| RHP100112 | Denied | $153.40 |
| RHP100114 | Underpaid | $12.32 |
| RHP100116 | Partially denied | $118.00 |
| RHP100117 | Denied | $153.40 |
| RHP100118 | Partially denied | $118.00 |
| RHP100119 | Denied | $68.44 |
| RHP100151 | Paid as expected | $0.00 |
| RHP100154 | Underpaid | $13.24 |
| RHP100231 | Underpaid | $153.99 |
| RHP100401 | Underpaid | $76.46 |
| RHP100405 | Underpaid | $153.99 |
| RHP100406 | Denied | $215.94 |
| RHP100411 | Underpaid | $111.51 |
| RHP100417 | Underpaid | $76.46 |
| RHP100419 | Denied | $306.80 |
| RHP100421 | Underpaid | $153.99 |
| RHP100427 | Underpaid | $111.51 |
| RHP100432 | Denied | $112.10 |
| RHP100433 | Underpaid | $76.46 |
| RHP100437 | Underpaid | $153.99 |
| RHP100443 | Underpaid | $111.51 |
| RHP100445 | Denied | $283.20 |
| RHP100449 | Underpaid | $76.46 |
| RHP100453 | Underpaid | $153.99 |
| RHP100459 | Underpaid | $111.51 |
| RHP100801 | Underpaid | $76.46 |
| RHP100805 | Underpaid | $153.99 |
| RHP100809 | Denied | $259.60 |
| RHP100811 | Underpaid | $111.51 |
| RHP100817 | Underpaid | $76.46 |
| RHP100821 | Underpaid | $153.99 |
| RHP100822 | Denied | $215.94 |
| RHP100827 | Underpaid | $111.51 |
| RHP100833 | Underpaid | $76.46 |
| RHP100835 | Denied | $306.80 |
| RHP100837 | Underpaid | $153.99 |
| RHP100843 | Underpaid | $111.51 |
| RHP100848 | Denied | $112.10 |
| RHP100849 | Underpaid | $76.46 |
| RHP100853 | Underpaid | $153.99 |
| RHP100859 | Underpaid | $111.51 |
| RHP101201 | Underpaid | $76.46 |
| RHP101205 | Underpaid | $153.99 |
| RHP101211 | Underpaid | $111.51 |
| RHP101212 | Denied | $68.44 |
| RHP101217 | Underpaid | $76.46 |
| RHP101221 | Underpaid | $153.99 |
| RHP101225 | Denied | $259.60 |
| RHP101227 | Underpaid | $111.51 |
| RHP101233 | Underpaid | $76.46 |
| RHP101237 | Underpaid | $153.99 |
| RHP101238 | Denied | $215.94 |
| RHP101243 | Underpaid | $111.51 |
| RHP101249 | Underpaid | $76.46 |
| RHP101251 | Denied | $306.80 |
| RHP101253 | Underpaid | $153.99 |
| RHP101259 | Underpaid | $111.51 |
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Denial reasons
| Reason | Claims | At stake |
|---|---|---|
| 197 Prior authorization missing | 3 | $920.40 |
| 22 Another payer may be primary | 3 | $647.82 |
| 50 Not medically necessary | 2 | $519.20 |
| 27 After coverage ended | 2 | $436.60 |
| 18 Exact duplicate | 2 | $374.06 |
| 4 Modifier does not fit the code | 3 | $342.20 |
| 96 Non-covered charge | 2 | $186.44 |
| 29 Filing deadline passed | 1 | $153.40 |
| 16 Missing or invalid information | 1 | $68.44 |
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Payments
| Paid | Trace number | Amount |
|---|---|---|
| Aug 17, 2026 | GP99900000544 | $22,896.44 |
| Aug 31, 2026 | GP99900000587 | $21,833.51 |
| Sep 28, 2026 | GP99900000631 | $22,241.16 |
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Contracted fee schedule
The allowed amount per unit this payer agreed to. Every payment is checked against it.
| Code | Service | Contract rate |
|---|---|---|
| 11102 | Skin biopsy | $118.00 |
| 20610 | Large joint injection | $76.70 |
| 27447 | Total knee replacement | $1,711.00 |
| 29827 | Shoulder arthroscopy, rotator cuff repair | $1,239.00 |
| 29881 | Knee arthroscopy with meniscectomy | $849.60 |
| 36415 | Blood draw | $3.54 |
| 45380 | Colonoscopy with biopsy | $448.40 |
| 64483 | Epidural steroid injection, lumbar | $283.20 |
| 71046 | Chest x-ray, two views | $41.30 |
| 73721 | MRI of a leg joint | $306.80 |
| 80053 | Metabolic panel | $12.98 |
| 85025 | Complete blood count | $9.44 |
| 90471 | Vaccine administration | $20.06 |
| 90686 | Flu vaccine | $23.60 |
| 93000 | Electrocardiogram | $20.06 |
| 93306 | Echocardiogram, complete | $259.60 |
| 97110 | Therapeutic exercise, 15 minutes | $34.22 |
| 99203 | New patient visit, low complexity | $132.16 |
| 99204 | New patient visit, moderate complexity | $200.60 |
| 99213 | Established patient visit, low complexity | $108.56 |
| 99214 | Established patient visit, moderate complexity | $153.40 |
| 99215 | Established patient visit, high complexity | $215.94 |
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