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SL-2026-0186Gathering docs Advance funded

K. Mitchell

Member M-13201 · Spinal Surgery · Cascade Manufacturing

Member workspace
AR
Aisha Robinson
Assigned owner
Summary
Member
K. Mitchell
Diagnosis
Spinal Surgery
M48.062
Carrier
Tokio Marine HCC
Total claims
$152,000
Spec deductible
$150,000
Amount to file
$2,000
claims above spec deductible
Source: Javelina
Packet 20 days old — stale, refresh before submitting
Packet checklist0/7
Draft filing packet
Packet ready to file
Claim ledger
SL-2026-0186-submission-1-claim-ledger.xlsx
Paid claims from Jan 1, 2026 to May 27, 2026
Combined PDF
SL-2026-0186-submission-1-filing-packet.pdf
Auto cover sheet + checklist supporting documents
Submission 1 · Initial filing
Ready-to-file draft packet. Applies the $150,000 spec deductible and requests $2,000 above deductible. Template: Platform reimbursement request form.
Current cumulative paid
$152,000
Last filed cumulative paid
None yet
New eligible paid
$2,000
Filing creation threshold
$0
Current filing record
SL-2026-0186-F01 · Initial filing
Draft
Paid periodJan 1, 2026 to May 27, 2026
Spec applied$150,000
Amount to request$2,000
Cumulative paid through$152,000
Filing threshold$0
Printed claim threshold$10,000

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

Claim detail
Claim Details
DateProviderDx codeAmount
2026-02-24Cleveland Clinic — NeurosurgeryM48.062$94,240
2026-04-10Cleveland Clinic RehabM48.062$33,440
2026-05-10CVS PharmacyM48.062$24,320
Total$152,000
Submit packet to carrier
Advance-funded
Plan files first, carrier funds the disbursement, plan mails check to provider. Filing speed = provider wait time.
Documents0/7 required
Pushback risk cleared3/3 cleared
Activity
  1. Spec deductible triggered
    May 25, 2026
  2. Claim ledger auto-pulled from Javelina
    May 25, 2026
  3. Just triggered · system building claim ledger and COB
    Auto-pulled docs landing now. Pre-cert and case management files can be uploaded locally when available.
Carrier risk checks
Carrier pushback risk