CLM-1022Daniel KingNo ResponseSLA Medium87% AI
Medicare · Medicare · Assigned to Sarah Mitchell · Updated 2026-04-22
Patient Name
Daniel King
Patient ID
PT-10053
Claim ID
CLM-1022
Visit ID
26021
Payer
Medicare
Payer ID
P00115
Carrier Plan
ASDPLANS12
Line of Business
Medicare
Provider
Dr. Mira Chen
Provider NPI
1098765432
Billing Group
BILL5
Date of Service
2026-04-01
Charge Posted
2026-04-02
Charge Amount
$953.00
Paid Amount
$502.00
Adjusted Amount
$33.00
Insurance Balance
$430.00
Patient Balance
$21.00
Primary Payer
Medicare
Secondary Payer
N/A
Tertiary Payer
N/A
Crossover
Yes
Assigned To
Sarah Mitchell
SLA Target
24h
SLA Elapsed
44h
SLA Risk
Medium
AI Adjudication Recommendation
Write Off Eligible
87%
Write Off Eligible. Based on payer Medicare, reason codes, and historical patterns, recommended action with 87% confidence.
Evidence: reason codes none; payer history; matched 835 rule.
Risk flags: none
Suggested next action: Write Off Eligible