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SL-2026-0151Filed — pendingCaught up Advance funded

J. Smith

Member M-03319 · Oncology · Atlas Tech Group

Member workspace
JT
James Torres
Assigned owner
Summary
Member
J. Smith
Diagnosis
Oncology
C50.912
Carrier
Voya Financial
Total claims
$245,000
Spec deductible
$125,000
Amount to file
$120,000
claims above spec deductible
Filed
$120,000
Reimbursed
$0
Outstanding
$120,000
Source: Cigna
Packet 43 days old — stale, refresh before submitting
Packet checklist7/7
Filing output and history
Filing output
Claim ledger
SL-2026-0151-submission-2-claim-ledger.xlsx
Paid claims from May 4, 2026 to May 3, 2026
Combined PDF
SL-2026-0151-submission-2-filing-packet.pdf
Auto cover sheet + checklist supporting documents
Submission 2 · Subsequent incremental filing
Subsequent filing is incremental: new eligible paid claims since the last filed cumulative paid amount. Template: Platform reimbursement request form.
Current cumulative paid
$245,000
Last filed cumulative paid
$245,000
New eligible paid
$0
Filing creation threshold
$1,000
Filing records for this member
SL-2026-0151-F01 · Initial filing
Submitted
Paid periodJan 1, 2026 to May 3, 2026
Spec applied$125,000
Filed amount$120,000
Cumulative paid through$245,000
Filing threshold$1,000
Printed claim threshold$10,000

Initial filing applied the specific deductible and set the last filed cumulative paid amount for future filings.

SL-2026-0151-F02 · Subsequent filing
Watching
Paid periodMay 4, 2026 to May 3, 2026
Spec applied$0
New eligible paidNo new paid claims yet
Cumulative paid through$245,000
Filing threshold$1,000
Printed claim threshold$10,000

Future treatment would open as a separate filing once new eligible paid claims meet the configured filing creation threshold.

Claim detail
Claim Details
DateProviderDx codeAmount
2026-01-17Memorial Sloan KetteringC50.912$151,900
2026-03-03MSK Infusion CenterC50.912$53,900
2026-04-02Accredo Specialty (chemo)C50.912$39,200
Total$245,000
Communication history
Communication1 message
From usclaims@voyafinancial.com
May 3, 2026
[SL-2026-0151] Oncology stop-loss filing — J. Smith

Stop-loss claim filing for J. Smith (M-03319). Attached: claim ledger flat file plus combined PDF packet with supporting docs.

SL-2026-0151-claim-ledger.xlsx SL-2026-0151-filing-packet.pdf fee-invoices.pdf um-case-management-notes.pdf aaw-cob-forms.pdf
Awaiting carrier
Filed 43 days ago. Auto follow-up at 7 day SLA.
Last update 24 days ago. Our work is done — pinging carrier if needed.
Stuck on
Carrier
Waiting on carrier review
24 days since last meaningful update
Activity
  1. Spec deductible triggered
    Apr 17, 2026
  2. Filed to carrier
    May 3, 2026·James Torres
  3. 21-day carrier follow-up due
    May 24, 2026
    No carrier response 21 days after filing; send status request.
  4. Filed and waiting · monitoring for carrier response
    24 days since filed. Auto follow-up on carrier scheduled at SLA.
Carrier risk checks
Carrier pushback risk