Fictional test clinic data for Maple Street Counselling. Nothing here is sent to a payer, a client, or the owner.

claimclearai

Denials and appeals

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Test clinic data2 waiting

Appeal

Due in 5 days

$187.50

Sam Okonkwo

Appeal · Missing authorization

Claim: CLM-10391
Payer: Northwind Health
Amount: $187.50
Provider: Dr. Amira Cole, LPC
Date of service: October 24, 2026
Denied: November 3, 2026
Procedure: 90837
Diagnosis: F41.1
Denial reason: Missing authorization
Authorization: AUTH-7721
Authorization submitted: October 10, 2026
Verbal confirmation: October 17, 2026
Due: November 17, 2026, in 5 days
Member ID: NW-441908

Why the bot prepared this

Northwind Health denied claim CLM-10391 on November 3, 2026 for missing authorization. The chart shows prior authorization AUTH-7721, submitted October 10 and verbally confirmed on October 17, before the October 24 visit with Dr. Amira Cole. The bot drafted an appeal that cites that authorization. It is waiting here because an appeal leaves the practice only after a person approves it.

Appeal letter

Northwind Health
Appeals review

Re: Appeal of claim CLM-10391
Member: Sam Okonkwo
Member ID: NW-441908
Provider: Dr. Amira Cole, LPC
Practice: Maple Street Counselling
18 Maple Street, Oakridge, ON  A1A 1A1
Date of service: October 24, 2026
Procedure: 90837
Diagnosis: F41.1
Charge: $187.50
Denial date: November 3, 2026
Denial reason: missing authorization

Maple Street Counselling appeals the denial of claim CLM-10391.

Prior authorization AUTH-7721 was submitted on October 10, 2026 for ongoing psychotherapy, procedure 90837. Northwind Health gave verbal confirmation of AUTH-7721 on October 17, 2026, before the visit. The session on October 24, 2026 was a 60-minute individual psychotherapy visit with Dr. Amira Cole for generalized anxiety disorder (F41.1). The authorization was active on the date of service.

Please reprocess claim CLM-10391 under AUTH-7721 and release payment of $187.50.

This letter is a draft held inside claimclearai. It leaves the practice only after a person approves it. Nothing has been sent to Northwind Health.

Maple Street Counselling
Billing desk

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