← Revenue worklist
REV-CLM-3101
BundlingAssignedFictional TRH demo — synthetic claim id · no PHIBlue Cross and Blue Shield of Texas · Outpatient · APC 5072 (Level 2 imaging)
Expected-vs-paid calculation
Expected (contract allowed)
$2,640
Paid (remittance)
$1,990
Variance
$650
Rate basis: Separately payable allowed $2,640
Contract term: BCBSTX Exhibit 2 §3 Unbundling rules
Denial / adjustment reason: CO-97 bundled into primary procedure
Ownership & confidence
- Owner
- C. Ford
- Confidence
- 74 / 100
- Claim age
- 44 days
- Recovery action
- Dispute bundling with NCCI modifier evidence per Exhibit 2 §3.
Evidence provenance
- Evidence
- BCBSTX 835 batch A · line 61
- Linked agreement
- Statewide Blue Plan Participation Agreement
- Linked payer
- Blue Cross and Blue Shield of Texas
Recovery workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-05-28 — REV-CLM-3101 surfaced by VERIFY expected-vs-paid rule from the 835/837 batch extract · FY2026 Q3 (Apr–Jun 2026).
- seed2026-05-28 — Contract term matched; expected allowed amount recomputed from loaded rate basis.