AI Claims Adjudication Workbench

ERA Details · CHK-104928

Premera Blue Cross · $2,000.00 · 0/10 posted · 2 errors · Unreconciled

Carrier Plan & Code (ERA)
Premera Blue Cross - PBCOMM01
Carrier Plan & Code (System)
Premera Commercial Plan - PBCOMM01
ERA Received Date
2026-04-28
ERA Deposit Date
2026-04-29
Payer
Premera Blue Cross
Check Number
CHK-104928
Check Amount
$2,000.00
Posted Amount
$0.00
Posted Visits
0 / 10
ERA Status
Pending
Debit Adjustment
$0.00
PLB
$0.00
Payment Method
EFT
Reconciliation
Pending
Visit IDClaim IDDOSPatientChargePaidIns BalPat BalStatusReadyAI RecommendationActions
25998CLM-2599804/28/2026Emily Johnson$369.00$200.00$0.00$169.00Scheduled
Ready for posting
25999CLM-2599904/28/2026William Anderson$240.00$180.00$0.00$60.00Scheduled
Ready for posting
26000CLM-2600004/28/2026Sophia Clark$510.00$410.00$0.00$100.00Scheduled
Ready for posting
26002CLM-2600204/28/2026Benjamin Lewis$199.00$159.00$0.00$40.00Scheduled
Ready for posting
26003CLM-2600304/28/2026Ava Robinson$870.00$720.00$0.00$150.00Scheduled
Ready for posting
26004CLM-2600404/28/2026Henry Walker$320.00$256.00$0.00$64.00Scheduled
Ready for posting
26005CLM-2600504/28/2026Mia Young$450.00$360.00$0.00$90.00Scheduled
Ready for posting
26006CLM-2600604/28/2026Samuel Hall$612.00$489.00$0.00$123.00Scheduled
Ready for posting
25996CLM-2599604/28/2026Olivia Martinez$369.00$200.00($369.00)$4.00Error
Apply CO45 contractual adjustment and PR2 Bill Next allocation, then schedule for posting.
Confidence 91%
26001CLM-2600104/28/2026James Wilson$500.00$0.00$500.00$0.00Error
Apply bulk denial handling for CO197 across all procedure lines (Documentation Required).
Confidence 88%