← Revenue worklist
REV-CLM-3203
UnderpaymentClosed — no recoveryFictional TRH demo — synthetic claim id · no PHIAetna · Inpatient medical · DRG 190 (COPD w/ MCC)
Expected-vs-paid calculation
Expected (contract allowed)
$11,260
Paid (remittance)
$11,260
Variance
$0
Rate basis: DRG allowed $11,260
Contract term: Aetna §3.2 DRG base
Denial / adjustment reason: Reconciled — paid to contract
Ownership & confidence
- Owner
- C. Ford
- Confidence
- 12 / 100
- Claim age
- 12 days
- Recovery action
- No action — expected equals paid; retained for audit completeness.
Evidence provenance
- Evidence
- Aetna 835 batch B · line 150
- Linked agreement
- Commercial Payer Participation Agreement
- Linked payer
- Aetna
Recovery workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-07-01 — REV-CLM-3203 surfaced by VERIFY expected-vs-paid rule from the 835/837 batch extract · FY2026 Q3 (Apr–Jun 2026).
- seed2026-07-01 — Contract term matched; expected allowed amount recomputed from loaded rate basis.