Auth Connell

PATIENT NAME AMOUNT PROVIDER DOS TASK PERFORMED

BROWN, LARRY $ 700.00 TN 6/17/2021 AGING

RAMOS, ANTHONY $ 1,400.00 TN 6/19/2021 AGING

SMITH, KAMI $ 1,200.00 TN 6/19/2021 AGING

ROSENESTEIN, JAIME $ 1,400.00 TN 6/17/2021 AGING

BANDHAUER, KATHLEEN $ 2,200.00 TN 6/7/2021 AGING

O CONNELL, NICOLE $ 1,400.00 TN 6/7/2021 AGING

HASS, ROBIN $ 1,200.00 TN 6/23/2021 AGING

NUNEZ, VIRGINIA $ 1,700.00 TN 5/20/2021 AGING

ROBINSON, SAVANNAH $ 1,500.00 TN 6/8/2021 AGING

RODRIGUEZ, BERNICE $ 2,000.00 TN 6/23/2021 AGING

DELABARRE, DEANN $ 1,200.00 TN 3/31/2021 AGING

HERNANDEZ, ROBERT $ 900.00 TN 6/24/2021 AGING

MANALANG, ISAIAS $ 87.53 TN 6/2/2021 AGING

BECK, INEZ $ 1,500.00 TN 6/15/2021 AGING

RODMAN, STEVEN $ 133.06 TN 4/28/2021 AGING

JOHNSON, JARVIS $ 1,200.00 TN 6/2/2021 AGING

PERKINS, ARETHA $ 1,050.00 TN 3/15/2021 AGING

FEDOROVA, TATYANA $ 159.00 TN 5/25/2021 AGING

JOHNSON, ALAN $ 1,200.00 TN 6/15/2021 AGING

STEWARD, CYNTHIA $ 1,200.00 TN 4/28/2021 AGING

HAMILTON, DEBRA $ 114.36 TN 3/2/2021 AGING

FONTENETTE, TANISHA $ 250.00 TN 2/23/2021 AGING

GALACGAC, CRISPIN $ 87.53 TN 5/24/2021 AGING

HARRIS, DIANE $ 1,200.00 TN 3/24/2021 AGING

MARTIN, MICHELLE $ 2,600.00 TN 6/9/2021 AGING

HARRIS, KAREN $ 1,200.00 TN 5/5/2021 AGING

ZELEZ, JENNIFER $ 1,400.00 TN 5/12/2021 AGING

TUCKER, DAKOTA $ 800.00 TN 5/19/2021 AGING

FEIGINOV, SEMEN $ 114.36 TN 4/27/2021 AGING

KATZ, LOUIS $ 87.53 TN 2/17/2021 AGING

LOBATO, ROBERT $ 2,600.00 TN 3/9/2021 AGING

HERNANDEZ, M RANGEL $ 87.53 TN 5/12/2021 AGING

REINCKE, ESTHER $ 1,400.00 TN 5/5/2021 AGING

TUFANO, MARK $ 2,600.00 TN 5/6/2021 AGING

WALTEMEYER, RUSHELLE $ 1,400.00 TN 6/2/2021 AGING

SPRINGER, JILLIAN $ 1,900.00 TN 6/26/2021 AGING

VAZQUEZ, JOSE $ 1,100.00 TN 6/19/2021 AGING

WITT, JANE $ 1,700.00 GV 7/19/2021 AGING

DE LUCA, EILEEN $ 2,700.00 GV 7/13/2021 AGING

WALKER, VIRGINIA $ 1,500.00 GV 6/29/2021 AGING

ANZAI, DIANE $ 159.00 GV 6/24/2021 AGING

HRUBES, MARILYN $ 1,500.00 GV 5/26/2021 AGING

BILLS, DENNIS $ 1,500.00 GV 5/26/2021 AGING

NEILSEN, LISA $ 524.00 GV 3/20/2021 AGING

PRICE, WILLIAM $ 50.00 GV 3/9/2021 AGING

WARNER, GAYLE $ 75.00 GV 2/27/2021 AGING

ELORIAGA, VANESSA $ 1,200.00 GV 2/22/2021 AGING

DOMINGUEZ, ANTONIO $ 66.90 GV 2/17/2021 AGING

SWINGER, JADEN $ 1,500.00 GV 7/27/2021 AGING

KASSINGER, MICHAEL $ 114.36 GV 6/24/2021 AGING

HEENAN, ROBERT $ 89.29 GV 6/25/2021 AGING

BILLER, MICHAEL $ 89.29 GV 6/25/2021 AGING

WALKER, DOROTHY $ 89.29 GV 6/26/2021 AGING

FORD, VIRGINIA $ 89.29 GV 6/28/2021 AGING

WEINSTEIN, MARY $ 114.36 GV 6/29/2021 AGING

HOLMES, JAYNE $ 159.00 GV 6/30/2021 AGING

CRISOSTOMO, JERRY $ 159.00 GV 6/4/2021 AGING

NASTASE, GARY $ 2,700.00 GV 6/17/2021 AGING

ADVIENTO, RUELITO $ 114.36 GV 4/20/2021 AGING

CARAVEL, LISA $ 35.41 GV 3/8/2021 AGING

SANDERS, SANDY $ 2,700.00 GV 4/27/2021 AGING

WEITEL, RICHARD $ 144.80 GV 1/20/2021 AGING

STAVISH, JOHN $ 89.29 GV 4/20/2021 AGING

HOLZMAN, TERRY $ 2,600.00 GV 6/25/2021 AGING

RAYOS, TANYA $ 1,200.00 GV 7/2/2021 AGING

ADVIENTO, RUELITO $ 114.36 GV 4/20/2021 AGING

CRAWFORD, GAIL $ 1,200.00 GV 3/5/2021 AGING

DAVIDSON, JAMES $ 87.53 GV 6/11/2021 AGING

MCGUIRE, CORRINE $ 159.00 GV 4/28/2021 AGING

STALTERI, KARIN $ 1,200.00 GV 4/28/2021 AGING

DOODY, THOMAS $ 89.29 GV 6/7/2021 AGING

DOODY, THOMAS $ 114.36 GV 4/19/2021 AGING

FREUND, NAOMI $ 89.29 GV 4/19/2021 AGING

PARRA, SALVADOR $ 1,500.00 GV 4/7/2021 AGING

BURNS, STEPHEN $ 107.75 DI 10/1/2020 AGING - VERACITY

LEE, HEI $ 174.70 DI 6/25/2020 AGING - VERACITY

GONZALEZ, JORGE $ 1,400.00 DI 6/22/2020 AGING - VERACITY

GONZALEZ, JERRY $ 109.08 TN 10/15/2020 AGING - VERACITY

MUKUMA, MIRIAM $ 151.76 TN 6/23/2020 AGING - VERACITY

ALPERT, KSENIYA $ 1,700.00 TN 2/26/2020 AGING - VERACITY

GRANLEE, SHERI $ 2,600.00 TN 12/11/2019 AGING - VERACITY

MELTZER, CAROL $ 1,800.00 TN 10/20/2020 AGING - VERACITY

NOTES

CORRESPONDANCE

PENDING

PENDING

PENDING

PENDING

PENDING

PENDING

PENDING COB UPDATE LM FOR PT SENT STMT

PENDING FOR MEDICAL RECORDS, SENT

PAID $429 ON 7/16/21

IN PROCESS

SENT FOR REPROCESS

PAID $343.20 ON 7/15/21

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED - MEDICAID DENIED

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

RE-BILLED REQUESTED REFERRING DR

REBILLED

RE-BILLED REQUESTED REFERRING DR

IN PROCESS

PENDING

DENIED NO AUTH IT WAS OBTAINED SENT RECONSIDERATION REQUEST ONLINE

PAID $427.97 ON 7/20/21

PAID $337.65 ON 7/30/21

REBILLED - REMOVED Z CODE

REBILLED - FIXED LAST NAME

REBILLED - REMOVED Z CODE

APPLIED TO DED

REBILLED - NOF

REBILLED - NOF

SUBMITTED PRIM EOB THROUGH WEBSITE

SUBMITTED PRIM EOB THROUGH WEBSITE

MEDICARE DENIED CANT FIND COVERAGE LEFT PT MESSAGE

DENIED NO AUTH SENT BILLING TASK TO KATHY AND LISA T TO GET A RETRO

SUBMITTED PRIM EOB THROUGH WEBSITE

REBILLED - FIXED ID#

SET TO PAY $114.36 ON 8/3/21

PENDING

PENDING

PENDING

PENDING

PENDING

PENDING

REBILLED - NOF

PAID $517.20 ON 8/3/21

REBILLED - NOF

SENT MEDICAL RECORDS PER REQUEST

SENT RECONSIDERATION REQUEST

REBILLED - NOF

APPLIED TO DED

PAID $602.10 ON 7/26/21

APPLIED TO DED

IN PROCESS

REBILLED - NOF

PAID $87.53 ON 6/29/21

PAID $159.00 ON 5/14/21

SENT EMAIL FOR STATUS

PAID BUT WASN’T POSTED

PAID BUT WASN’T POSTED

PAID BUT WASN’T POSTED

PENDING COB UPDATE LM FOR PT SENT STMT

SENT FOR REPROCESS

IN REVIEW

SENT BACK FOR REPROCESS

IN PROCESS

IN PROCESS

PER CHAMPVA OPENING PAPER CLAIMS RCVD 4/7/21 BARLEY

SENT FOR REPROCESS

SENT FOR REPROCESS

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