← Revenue worklist
REV-CLM-3003
UnderpaymentValidatedFictional TRH demo — synthetic claim id · no PHIUnitedHealthcare · Emergency · APC 5024 (Level 4 ED)
Expected-vs-paid calculation
Expected (contract allowed)
$1,310
Paid (remittance)
$1,180
Variance
$130
Rate basis: Level 4 allowed $1,310
Contract term: UHC §4.5 ED facility tiers
Denial / adjustment reason: Down-coded from level 4 to level 3
Ownership & confidence
- Owner
- M. Duran
- Confidence
- 78 / 100
- Claim age
- 27 days
- Recovery action
- Submit corrected claim with ED acuity documentation packet.
Evidence provenance
- Evidence
- UHC 835 batch B · line 205
- Linked agreement
- Commercial Payer Participation Agreement
- Linked payer
- UnitedHealthcare
Recovery workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-06-15 — REV-CLM-3003 surfaced by VERIFY expected-vs-paid rule from the 835/837 batch extract · FY2026 Q3 (Apr–Jun 2026).
- seed2026-06-15 — Contract term matched; expected allowed amount recomputed from loaded rate basis.