SL-2026-0172Ready to file Advance funded

S. Cohen

Member M-09022 · Oncology · Northern Logistics Co

Member workspace

James Torres

Assigned owner

Summary

Member

S. Cohen

Diagnosis

Oncology

C50.912

Carrier

Berkley Accident & Health

Total claims

$134,000

Spec deductible

$100,000

Amount to file

$34,000

claims above spec deductible

Source: Cigna

Packet 19 days old — stale, refresh before submitting

Packet checklist6/7

Draft filing packet

Packet ready to file

Claim ledger

SL-2026-0172-submission-1-claim-ledger.xlsx

Paid claims from Jan 1, 2026 to May 27, 2026

Combined PDF

SL-2026-0172-submission-1-filing-packet.pdf

Auto cover sheet + checklist supporting documents

Submission 1 · Initial filing

Ready-to-file draft packet. Applies the $100,000 spec deductible and requests $34,000 above deductible. Template: Platform reimbursement request form.

Current cumulative paid

$134,000

Last filed cumulative paid

None yet

New eligible paid

$34,000

Filing creation threshold

$1,000

Current filing record

SL-2026-0172-F01 · Initial filing

Draft

Paid periodJan 1, 2026 to May 27, 2026

Spec applied$100,000

Amount to request$34,000

Cumulative paid through$134,000

Filing threshold$1,000

Printed claim threshold$10,000

Initial filing applies the specific deductible; request amount is paid claims above deductible.

Claim detail

Claim Details

Date	Provider	Dx code	Amount
2026-02-13	Dana-Farber Cancer Institute	C50.912	$83,080
2026-03-30	Dana-Farber Infusion	C50.912	$29,480
2026-04-29	Walgreens Specialty Rx	C50.912	$21,440
Total			$134,000

Submit packet to carrier

Advance-funded

Plan files first, carrier funds the disbursement, plan mails check to provider. Filing speed = provider wait time.

Documents6/7 required

Pushback risk cleared3/3 cleared

Activity

Spec deductible triggered
May 14, 2026
Filing packet auto-assembled
May 14, 2026
Core packet review complete
May 27, 2026·James Torres
Required support documents are in; cover sheet generated for final review before submission
Packet ready · awaiting rep approval to file
Advance-funded — provider check is on hold pending carrier approval. File now to start the disbursement clock.

Carrier risk checks

Carrier pushback risk