CLM-2025-001849

Summit Outpatient Surgery Center · Medicare · 837I

Claims

CLM-2025-001849

Accepted
Summit Outpatient Surgery Center · Medicare
$4,820.00
Provider
Dr. Robert Chang
Patient Ref
PT-11823
Service Date
2025-01-13
Claim Type
837I

Billing Summary

Diagnosis Codes
M75.1M54.5
Procedure Codes
2744799231

Claim Timeline

Claim created and imported10:01 AM
Received via batch upload
MASE Rules Engine — Scrub initiated10:01 AM
8 rules evaluated
MASE AI Scrub completed10:02 AM
Passed all validation checks
Routed to Claim.MD adapter10:03 AM
claimmd-claims-adapter v2.1
Submitted to payer via Claim.MD10:04 AM
ISA batch 00421 · GS group 004
999 Acknowledgement received10:05 AM
AK2 accepted — Functional Group OK
MASE AI Scrub
Risk Score8 / 100
Scrub ResultPassed
Rules Evaluated8 / 8
AI Modelmase-scrub-v3.1
Claim.MD Transaction Trace
Routing StatusAcknowledged
Ack ResultAccepted
Adapterclaimmd-claims-adapter
ISA Batch00421
Recommended Next Action

Monitor claim status. Expected acknowledgement within 24 hours.