Fictional TRH demo data — no PHI
Harsight VERIFY
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REV-CLM-3103

Timely-filingNewFictional TRH demo — synthetic claim id · no PHI

Blue Cross and Blue Shield of Texas · Observation · APC 8011 (Observation)

Expected-vs-paid calculation
Expected (contract allowed)
$3,180
Paid (remittance)
$0
Variance
$3,180
Rate basis: Observation allowed $3,180
Contract term: BCBSTX §9 Filing limit (95 days)
Denial / adjustment reason: CO-29 timely filing exceeded

Ownership & confidence

Owner
M. Duran
Confidence
41 / 100
Claim age
96 days
Recovery action
Assess proof-of-timely-submission; likely write-off if unsupported.

Evidence provenance

Evidence
BCBSTX 835 denial batch C · line 88

Recovery workflow

Demo action — resets on reload · not persisted

Chronology & session activity

  • seed2026-04-08 — REV-CLM-3103 surfaced by VERIFY expected-vs-paid rule from the 835/837 batch extract · FY2026 Q3 (Apr–Jun 2026).
  • seed2026-04-08 — Contract term matched; expected allowed amount recomputed from loaded rate basis.