Claims & Insurance
Denial-risk scrubber · fix claims before they leave the building
5 at risk
Claims outstanding
$2.3K
submitted, not yet paid
Denied $
$3.5K
needs rework / appeal
At-risk claims
5
≥50% denial risk
Avg days to pay
29
clean-claim turnaround
Denial-risk scrubber
Every claim scored + reasoned before it leaves
| Claim | Payer / patient | Amount | Status | Denial risk / reason |
|---|---|---|---|---|
CLM-4009 D2950X | BlueRidge HMO Rosa Castellano | $805 | Denied | 97% Missing attachment (perio chart / X-ray) |
CLM-4010 D6010 | BlueRidge HMO Felix Nair | $1,505 | Denied | 80% Eligibility unverified at date of service |
CLM-4013 D2950X | BlueRidge HMO Cole Haddad | $805 | Denied | 72% Eligibility unverified at date of service |
CLM-4004 D2950 | BlueRidge HMO Tomas Adeyemi | $200 | Denied | 66% Missing attachment (perio chart / X-ray) |
CLM-4002 D2950 | BlueRidge HMO Leila Park | $200 | Denied | 66% Missing attachment (perio chart / X-ray) |
Scrub queue
5 fixable before submit
CLM-4009Rosa CastellanoDenied
Attachment$805
CLM-4010Felix NairDenied
Eligibility$1,505
CLM-4013Cole HaddadDenied
Eligibility$805
CLM-4004Tomas AdeyemiDenied
Attachment$200
CLM-4002Leila ParkDenied
Attachment$200
Payers & eligibility
Open billings by payer
BlueRidge HMOpending$1,973
HMO · 9 claims34d to pay
Cigna Northstaractive$221
PPO · 5 claims18d to pay
Delta Harbor PPOactive$72
PPO · 1 claim21d to pay
MetroCare Dentalactive$0
PPO · 1 claim26d to pay
Risk scores run through the same denial scorer as the Day Sheet; A/R ties to $2.3K insurance and $3.5K in denied claims.