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SL-2026-WL-11Gathering docs Advance funded
E. Garcia
Member M-01298 · Oncology · Northern Logistics Co
Member workspaceAR
Aisha Robinson
Assigned owner
Summary
Member
E. Garcia
Diagnosis
Oncology
C50.912
Carrier
Berkley Accident & Health
Total claims
$75,000
Spec deductible
$100,000
New eligible paid
$0
below $1,000 threshold
Source: Cigna
Packet 24 days old — stale, refresh before submitting
Packet checklist2/7
Filing threshold watch
Not ready to file yet
Claim ledger
SL-2026-WL-11-submission-1-claim-ledger.xlsx
Paid claims from Jan 1, 2026 to May 22, 2026
Combined PDF
SL-2026-WL-11-submission-1-filing-packet.pdf
Auto cover sheet + checklist supporting documents
Submission 1 · Initial filing
No filing draft yet. New eligible paid is $0, below the configured $1,000 filing creation threshold. Template: Platform reimbursement request form.
Current cumulative paid
$75,000
Last filed cumulative paid
None yet
New eligible paid
$0
Filing creation threshold
$1,000
Current filing record
SL-2026-WL-11-F01 · Initial filing
WatchingPaid periodJan 1, 2026 to May 22, 2026
Spec applied$100,000
New eligible paidNo new paid claims yet
Cumulative paid through$75,000
Filing threshold$1,000
Printed claim threshold$10,000
Member is over spec, but only $0 is newly eligible; wait until the configured $1,000 filing creation threshold is met.
Claim detail
Claim Details
| Date | Provider | Dx code | Amount |
|---|---|---|---|
| 2026-02-16 | Dana-Farber Cancer Institute | C50.912 | $46,500 |
| 2026-04-02 | Dana-Farber Infusion | C50.912 | $16,500 |
| 2026-05-02 | Walgreens Specialty Rx | C50.912 | $12,000 |
| Total | $75,000 | ||
Pre-stage monitoring
Member is at 75% of the $100,000 spec deductible. No filing yet — system is pre-assembling docs so we can file the moment cumulative claims cross spec.
Pre-staged docs2/7
Activity
- Member at 75% of spec — watchlist addMay 17, 2026
- Member COB info request sentMay 17, 2026
- Waiting on employer HR · active-at-work attestation pendingHR has been emailed for the active-at-work attestation. Auto follow-up at day 2.
Carrier risk checks
Carrier pushback risk