CLM-2025-001850
CardioVascular Associates of Texas · UnitedHealthcare · 837P
⌘K
AI Correction Recommendation
Procedure 93306 requires Modifier -26 for professional component when billed with 93458. Add TC/26 modifier split per UHC companion guide v4.7.
AI Confidence: High
CLM-2025-001850
FlaggedCardioVascular Associates of Texas · UnitedHealthcare
$3,150.00
Provider
Dr. Thomas Reyes
Patient Ref
PT-33910
Service Date
2025-01-15
Claim Type
837P
Billing Summary
Diagnosis Codes
I25.10I10
Procedure Codes
9345893306
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 Score72 / 100
Scrub ResultFlagged — Missing Modifier
Rules Evaluated8 / 8
AI Modelmase-scrub-v3.1
Claim.MD Transaction Trace
Routing StatusHeld
Ack ResultPending
Adapterclaimmd-claims-adapter
ISA Batch00421
Correction Checklist
Recommended Next Action
Review AI flag, apply required modifier, then release claim to Claim.MD routing queue.