CLM-2026-005

Not Generated

David Wilson · DOS Feb 3, 2026 · Cigna

Agent Reasoning

Patient Information

DW

David Wilson

DOB: Feb 18, 1965 · Male

(555) 567-8901

d.wilson@email.com

Fort Lauderdale, FL 33301

Insurance

Cigna

Member ID: CIG-554433

Group: GRP-7700

Effective: Jan 1, 2025

Primary

Medical Codes

28002

Incision and drainage, foot

Qty: 1

$1,600.00

Verified

Activity Timeline

Encounter recorded

Feb 3, 2026 · System

Billing Summary

Procedure Charge$1,600.00
Insurance PaysPending adjudication
Patient ResponsibilityPending adjudication
3 days pending

Risk Assessment

22
LOW RISK

Straightforward procedure

Cigna good approval rate

Predicted Payment$1,120.00
Expected DateMar 20, 2026
Confidence Interval$1,000.00 $1,280.00

Actions

Agent Reasoning