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Advanced Imaging

Radiology

Enhanced Provider Data
Professional Services
Service Date
Feb 7, 2026
Claim ID
SCAN-ERR-001
Provider NPI
Not Available
Status
Pending

Financial Breakdown

Coverage Details

Covered Service
Part B
No Deductible Required

This service was not covered by your insurance plan. This could be due to the service not being covered under your plan benefits, requiring prior authorization, or being considered not medically necessary.

Cost Breakdown

Provider Charged:$450.00
Medicare Allowed:$0.00
Medicare Paid:$0.00
Other Patient Costs:$450.00
Your Responsibility:$450.00

Coverage Insights

Processing Details:
  • Claim pending due to provider identification issue
  • NPI number on file does not match provider name

💡 These insights are derived from Medicare's adjudication data to help explain your coverage details.

AI Summary

Recent imaging service flagged for review. The provider billing name does not match the NPI records on file, which may delay processing or lead to denial.

AI analysis is for informational purposes only and should not replace professional medical or financial advice.

Risk Flags

Overcharges
No issues detected
Billing Errors
  • missing_provider_npi
Fraud Indicators
No issues detected
Duplicate Services
No issues detected
Appeal Opportunities
No issues detected
Non Covered Services
No issues detected

Insights

Claim Complexity
medium
Coverage Gaps Identified
Billing Accuracy Assessment
potential_error
Potential Savings Opportunities

Tags

billing-error
R07.9(ICD_10)AI Enhanced
Primary

Chest pain, unspecified

Unspecified chest pain. This diagnosis is often used when a patient presents with chest pain but a specific cause (like heart attack or infection) has not yet been determined or ruled out.

Specialty
General Practice
Category
Symptoms
Clinical Notes
This visit was likely to investigate the cause of the chest pain using imaging.

Present on admission: No

71046(CPT)AI Enhanced

Radiologic examination, chest; 2 views

$0.00
Medicare Paid

Chest X-ray, 2 views

Radiologic examination, chest; 2 views. A standard chest X-ray taken from two angles (usually front and side) to evaluate the lungs, heart, and chest wall.

Specialty
Diagnostic Radiology
Category
Radiology
Service: Feb 7, 2026
Provider charged
$450.00
Medicare Allowed
$0.00
Medicare Paid
$0.00
Your responsibility
$450.00

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