X12 Ingest & Denial Analytics

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Denials›BILLING_ERROR›claim B10M000817

Denial · CARC 16

BILLING_ERROR · MERIDIAN HEALTH PLAN

Denied
649.00
Withheld
Recoverable
649.00
Realistically collectable
Net of rework
618.00
less 31.00
Appeal window
4
Days left

Classification

FieldValue
Primary CARC16
All CARCs16
Root causeBILLING_ERROR
Owns the fixBilling Related
Appealableyes
Recoverableyes
Recommended actionClaim lacks information. Read the accompanying RARC for what is missing.
PayerMERIDIAN HEALTH PLAN
Denial date28 Jun 2026
Appeal deadline26 Sep 2026

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

What were we paid, and what can we still pursue?

$649.00 withheld, nothing paid

Billed $649.00. The payer paid $0.00, withheld $649.00. Of the $649.00 withheld, $649.00 is modelled as recoverable; less $31.00 to work it, that is $618.00 net. Claim lacks information. Read the accompanying RARC for what is missing. To pursue the withheld amount, quote the payer's own claim number from the remittance and the adjudication date 28 Jun 2026, and confirm the route and deadline with the payer.

From: 835 CLP amounts and CAS adjustments on this claim; the denial derivation for the modelled recoverable amount and filing window.

Limits: Patient responsibility reported on an 835 is not revenue. This application cannot say whether the practice billed it, whether the patient paid, or whether a secondary payer covered it — those live in a billing system it does not read. The recoverable figure and the deadline are estimates, not a payer commitment.

Adjustments

LevelCodeAmountCounts as
linePI/16649.00withheld