Aetna — Denial pattern detected
Appealable Denial
Potential recovery
$4,212
PayerFight detected that these claims appear inconsistent with the reimbursement terms currently on file for this payer.
The financial difference
Contracted reimbursement$155.00benchmark per service
Average actual reimbursement$132.00benchmark per service
Average difference$23.00illustrative benchmark
The comparison above illustrates the reimbursement benchmark. This opportunity also includes denial or payment adjustments, so its potential recovery is not calculated from the benchmark alone.
Affected claims
18 claims identified for review
| Claim ID | Provider | Date of Service | CPT | Billed | Expected | Paid | Difference | Status |
|---|---|---|---|---|---|---|---|---|
| PF-10566 | Dr. Maya Chen | 2026-09-01 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10567 | Dr. James Wilson | 2026-09-02 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10568 | Dr. Elena Brooks | 2026-09-03 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10569 | Dr. Marcus Reed | 2026-09-04 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10570 | Dr. Olivia Patel | 2026-09-05 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10571 | Dr. Noah Bennett | 2026-09-06 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10572 | Dr. Maya Chen | 2026-09-07 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10573 | Dr. James Wilson | 2026-09-08 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10574 | Dr. Elena Brooks | 2026-09-09 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10575 | Dr. Marcus Reed | 2026-09-10 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10576 | Dr. Olivia Patel | 2026-09-11 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10577 | Dr. Noah Bennett | 2026-09-12 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10578 | Dr. Maya Chen | 2026-09-13 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10579 | Dr. James Wilson | 2026-09-14 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10580 | Dr. Elena Brooks | 2026-09-15 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10581 | Dr. Marcus Reed | 2026-09-16 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10582 | Dr. Olivia Patel | 2026-09-17 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |
| PF-10583 | Dr. Noah Bennett | 2026-09-18 | 90791 | $350 | $234 | $0 | $234 | Appeal Opportunity |