Reconciliation Center

Match, resolve, and escalate transaction discrepancies across the claim lifecycle

Open Issues
6
Critical
1
High Priority
3
Revenue at Risk
$8K
Claim LimboREC-001CLM-2025-001839
MedBridge Billing Solutions · Cigna
$720.00
claim amount

Claim submitted 48+ hours ago with no 999/TA1 acknowledgement returned from Claim.MD. Claim state unknown.

Route: Claim.MD
Submitted: 1/13/2025
Stale since: 1/14/2025
Assigned: Recon Team Alpha
ERA MismatchREC-002CLM-2025-001801
Lakewood Family Medicine Group · Blue Cross Blue Shield
$1,180.00
claim amount

ERA received with payment but cannot be matched to original claim. Possible claim ID mismatch in BCBS 835 response.

Route: Claim.MD
Submitted: 1/8/2025
Stale since: 1/11/2025
Assigned: Recon Team Beta
Payer TimeoutREC-003CLM-2025-001815
CardioVascular Associates of Texas · UnitedHealthcare
$3,400.00
claim amount

Claim.MD returned HTTP 504 timeout on routing attempt. Claim status unknown — may or may not have reached UHC. Manual verification required.

Route: Claim.MD
Submitted: 1/11/2025
Stale since: 1/12/2025
Assigned: Infrastructure Team
UnderpaymentREC-004CLM-2025-001790
Summit Outpatient Surgery Center · Medicare
$1,020.00
claim amount

ERA payment of $4,180.00 received — variance of $1,020.00 vs billed $5,200.00. CO-45 contractual adjustment exceeds expected contracted rate.

Route: Claim.MD
Submitted: 1/5/2025
Assigned: Recon Team Alpha
Missing ERAREC-005CLM-2025-001822
Horizon Behavioral Health Partners · Humana
$890.00
claim amount

Claim accepted by payer 6 days ago with no ERA/835 received. Payment window elapsed. No claim status update (277) in queue.

Route: Claim.MD
Submitted: 1/9/2025
Stale since: 1/13/2025
Assigned: Recon Team Beta
Duplicate PaymentREC-006CLM-2025-001778
MedBridge Billing Solutions · Blue Cross Blue Shield
$520.00
claim amount

ERA shows duplicate payment received for same claim ID. Second remittance posted 5 days after original — likely a BCBS batch error. Must recoup.

Route: Claim.MD
Submitted: 1/3/2025
Assigned: Recon Team Alpha

Lifecycle Summary — January 2025

28,400
Claims Submitted
24,380
Routed via Claim.MD
24,210
Acknowledged
7,842
ERAs Received
7,803
Payments Matched
5
Unresolved