Product / The Worklist
Every dispute, ordered by what it’s worth and when it dies.
Not by raw dollars — the largest variances are disproportionately write-offs. Each finding is weighted by how confident the engine is that it’s real, and by how often its class is overturned. The deadline beside it carries the regulation it was computed from.
PCN1003 · Aetna Medicare Advantage
Medical necessity — CO-50
$2,100.00
at stake
Why this is a dispute
| Billed | $2,640.00 |
| Allowed under contract | $2,100.00 |
| Paid | $0.00 |
| Adjustment taken | CO-50 · $2,640.00 |
| Recoverable | $2,100.00 |
Group code CO with no patient responsibility — the payer is asserting the service wasn’t covered, not that the patient owes it.
Evidence assembled
- Payer policy 0034, rev. in force 2026‑04‑18 3 of 4 criteria met, quoted
- Contract rate sheet §4.2, verified Allowed amount confirmed
- Chart excerpt conservative therapy, 6 weeks Waiting on your office
- Appeal due 2026‑09‑01 60 days · 42 CFR §422.582
Draft written and cite-checked —
every factual sentence traced to a quote above. Nothing files until
you approve it.
- Needs review — a completed, cited draft is waiting for a two-minute approval.
- Waiting on you — the one ask we make: a chart excerpt or a signature only your office has.
- Filed — transmitted, with the confirmation artifact archived.
- Recovered — posted on a remittance. The only column we ever invoice against.