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SL-2026-WL-19Gathering docs Advance funded
M. Davis
Member M-08801 · NICU · Atlas Tech Group
Member workspaceJT
James Torres
Assigned owner
Summary
Member
M. Davis
Diagnosis
NICU
P07.25
Carrier
Voya Financial
Total claims
$106,000
Spec deductible
$125,000
New eligible paid
$0
below $1,000 threshold
Source: Cigna
Packet 21 days old — stale, refresh before submitting
Packet checklist5/7
Filing threshold watch
Not ready to file yet
Claim ledger
SL-2026-WL-19-submission-1-claim-ledger.xlsx
Paid claims from Jan 1, 2026 to May 25, 2026
Combined PDF
SL-2026-WL-19-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
$106,000
Last filed cumulative paid
None yet
New eligible paid
$0
Filing creation threshold
$1,000
Current filing record
SL-2026-WL-19-F01 · Initial filing
WatchingPaid periodJan 1, 2026 to May 25, 2026
Spec applied$125,000
New eligible paidNo new paid claims yet
Cumulative paid through$106,000
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 |
|---|---|---|---|
| 2026-02-26 | Children's Hospital of Philadelphia — NICU | P07.25 | $76,320 |
| 2026-03-13 | CHOP Imaging | P07.25 | $16,960 |
| 2026-04-27 | Pediatrix Medical Group | P07.25 | $12,720 |
| Total | $106,000 | ||
Pre-stage monitoring
Member is at 85% of the $125,000 spec deductible. No filing yet — system is pre-assembling docs so we can file the moment cumulative claims cross spec.
Pre-staged docs5/7
Activity
- Member at 85% of spec — watchlist addMay 22, 2026
- COB query sent via insurance discovery APIMay 22, 2026
- Almost ready · only case management notes outstandingCase management notes are the last item — clinical team upload pending.
Carrier risk checks
Carrier pushback risk