Denial worklist
Open appeal windows first, nearest deadline first, then the money; closed windows follow, most recently closed first.
This worklist is where the summary pages lead: the denials behind whatever you selected, with open appeal windows first and the nearest deadline at the top. Closed windows follow as history. Select a reason code to open the denial itself: its adjustments, and what it means to each role.
root cause MEDICAL_NECESSITY×
| Appeal window | CARC | Root cause | Owns the fix | Payer | Denied | Net |
|---|---|---|---|---|---|---|
| 129 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 69.06 | 38.06 |
| 129 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 31.02 | 0.02 |
| 129 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 0.00 | 0.00 |
| 134 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 492.00 | 461.00 |
| 134 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 120.13 | 89.13 |
| 134 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 143 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 31.52 | 0.52 |
| 143 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 0.00 | 0.00 |
| 143 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 0.00 | 0.00 |
| 149 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 744.00 | 713.00 |
| 149 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 319.00 | 288.00 |
| 149 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 90.00 | 59.00 |
| 149 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 149 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 149 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 157 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 106.00 | 75.00 |
| 157 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 75.00 | 44.00 |
| 164 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 779.00 | 748.00 |
| 164 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 64.00 | 33.00 |
| 164 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 21.10 | below cost |
| 171 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 496.00 | 465.00 |
| 171 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 177.00 | 146.00 |
| 171 | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 0.00 | 0.00 |
| 194 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 314.00 | 283.00 |
| 194 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 189.00 | 158.00 |
| 194 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 150.00 | 119.00 |
| 194 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 29.53 | below cost |
| 209 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 699.00 | 668.00 |
| 209 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 502.00 | 471.00 |
| 209 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 267.00 | 236.00 |
| 209 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 262.00 | 231.00 |
| 209 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 55.39 | 24.39 |
| 209 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 224 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 546.00 | 515.00 |
| 224 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 215.00 | 184.00 |
| 224 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 224 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 224 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 224 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 239 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 559.00 | 528.00 |
| 239 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 305.00 | 274.00 |
| 239 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 294.00 | 263.00 |
| 239 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 239 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 239 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 4.67 | below cost |
| 254 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 347.04 | 316.04 |
| 254 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 69.92 | 38.92 |
| 254 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 254 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 23.62 | below cost |
| 269 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 310.08 | 279.08 |
| 269 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 284 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 780.00 | 749.00 |
| 284 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 658.00 | 627.00 |
| 284 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 284 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 466.00 | 435.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 367.00 | 336.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 160.68 | 129.68 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 92.00 | 61.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 299 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 314 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 665.00 | 634.00 |
| 314 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 314 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 314 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 314 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 329 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 164.00 | 133.00 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 512.00 | 481.00 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 352.30 | 321.30 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 129.00 | 98.00 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| 344 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 17.55 | below cost |
| 359 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 326.00 | 295.00 |
| 359 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 191.10 | 160.10 |
| 359 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 158.00 | 127.00 |
| 359 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 150.25 | 119.25 |
| 359 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 61.00 | 30.00 |
| 359 | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 463.00 | 432.00 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 340.96 | 309.96 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 197.00 | 166.00 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| closed 1d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 0.00 | 0.00 |
| closed 3d ago | 50 | MEDICAL_NECESSITY | Utilization | MERIDIAN HEALTH PLAN | 0.00 | 0.00 |
| closed 3d ago | 50 | MEDICAL_NECESSITY | Utilization | MERIDIAN HEALTH PLAN | 0.00 | 0.00 |
| closed 3d ago | 50 | MEDICAL_NECESSITY | Utilization | MERIDIAN HEALTH PLAN | 25.44 | below cost |
| closed 10d ago | 50 | MEDICAL_NECESSITY | Utilization | MERIDIAN HEALTH PLAN | 344.00 | 313.00 |
| closed 10d ago | 50 | MEDICAL_NECESSITY | Utilization | MERIDIAN HEALTH PLAN | 0.00 | 0.00 |
| closed 11d ago | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 634.00 | 603.00 |
| closed 11d ago | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 234.40 | 203.40 |
| closed 11d ago | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 112.90 | 81.90 |
| closed 11d ago | 50 | MEDICAL_NECESSITY | Utilization | NORTHSTAR MUTUAL | 0.00 | 0.00 |
| closed 16d ago | 50 | MEDICAL_NECESSITY | Utilization | CASCADE CARE | 778.00 | 747.00 |
| Total | 17,136.66 | 15,276.66 |