Total denied
8
claims this period
Revenue at risk
$20,197
total billed, unpaid
Recoverable
$14,217
5 claims appealable
Avg claim value
$2,525
per denied claim
Recovery pipeline
Denied
AI reviewed
Appealable
Won
Top denial reason: "Medical necessity not established" — this single reason is driving the most lost revenue. Focus your appeals here first.
Denied claims
| Claim ID | Patient | Date of service | Code | Denial reason | Amount | Days open | Status | |
|---|---|---|---|---|---|---|---|---|
| CLM-1001 | Jane Martinez | 2025-03-12 | 99213 | Medical necessity not established | $1,250.00 | 496d | Appealable | Appeal → |
| CLM-1002 | Robert Chen | 2025-02-28 | 27447 | Prior authorization not obtained | $8,420.50 | 508d | Appealable | Appeal → |
| CLM-1003 | Emily Davis | 2025-04-01 | 93000 | Duplicate claim | $320.00 | 476d | Hard denial | Review |
| CLM-1004 | Michael Brown | 2025-03-05 | 45378 | Incorrect procedure code | $2,890.75 | 503d | Appealable | Appeal → |
| CLM-1005 | Sarah Wilson | 2025-01-15 | 99285 | Timely filing limit exceeded | $4,100.00 | 552d | Hard denial | Review |
| CLM-1006 | James Lee | 2025-03-20 | 70450 | Missing documentation | $980.25 | 488d | Appealable | Appeal → |
| CLM-1007 | Lisa Anderson | 2025-02-10 | 97110 | Service not covered under plan | $1,560.00 | 526d | Hard denial | Review |
| CLM-1008 | David Kim | 2025-04-08 | 99214 | Coordination of benefits required | $675.50 | 469d | Appealable | Appeal → |