Payment integrity Claim audit
Centene · payment integrity
Audit queue/ AUD-2026-04-0001/ CLM-0000005
Claim 6 of 25 Previous Next claim Back to queue

Post-pay review · Dr. Jane Smith

Marketplace Member MBR-88109443 DOS 27 Mar 2026 Paid 01 Apr 2026 · $133.60 Recovery window closes in 47 days
Eligibility: Active on the date of service Coverage at risk Ambetter Gold 80 HMO · Texas Prior auth: Not required Professional service
Review closing letter

As paid vs. as it should have been

No variance
LnCodeDescription PaidShould be VarianceResult
1 99214 Office or other outpatient visit, established patient, moderate complexity
E11.9 · Type 2 diabetes mellitus without complications
$133.60 $133.60 Correct

Determination

No defect in any layer

Reviewed with no variance. Every line was paid at the allowable on file.

How it was coded

Coded as documented
Billed As documented
Supported by the record As documented

Remedy: None — the claim was billed and priced as the record supports

Reviewed for level, severity and unit count. Nothing billed above what the record carries.

Prior authorization

Not required
Requirement Not required

No prior authorization requirement for this service on this plan.

Policy applied

Knowledge Center

Resolved as at the date of service, 27 Mar 2026 — not as at today.

CPP-080 Eligibility, enrolment and retroactive termination Decisive

Coverage on the date of service, and the grace-period rule that applies to it

In force on 27 Mar 2026: v6.1 effective 2026-01-01
From CPP-080 v6.1, retrieved for this claim

4. Variations by state and line of business 4.1 Marketplace qualified health plans A member receiving an advance premium tax credit has a three-month grace period for non-payment of premium. Claims for services in the first month are paid. Claims in months two and three may be pended and, if the premium is not paid by…

e termination after the date of service creates no exposure. 4.3 Medicare Advantage A retroactive disenrolment processed by CMS makes the plan not liable for the period concerned. Reconciliation follows the monthly membership report.

v6.1 had been in force for 85 days when this service happened. Before it, v6.0 applied — “Baseline. Eligibility verified once, at adjudication.”
CPP-014 Evaluation and management level selection Supporting

Level selection for the visit billed

In force on 27 Mar 2026: v4.2 effective 2026-01-01

v4.2 was extracted from CPP-014_em-level-selection_v4.2.md. Passages are quoted only on the policy the finding rests on.

Source document

Open all four views
837P_20260330_454243.edi
Availity clearinghouse · EDI 837P · received 30 Mar 2026 06:39 · claim control CCN-9525401133
Claim form As received EDI Remittance

How this was decided

Open the full trace

Walked through Professional claims post-pay review v1.9, signed off 2026-01-14.

Procedure SOP-PRO-01 — Professional claims — office visits, procedures, laboratory, imaging
Nodes walked 12
Model calls 0 — every node that resolved did so on a rule, a lookup or arithmetic
01 Apr 10:00 Claim paid, $133.60 released to provider Payment cycle
02 Apr 18:02 Selected for post-pay review Autonomize
07 Apr 09:30 Reviewed, no finding D. Mercer