G. Hayes
Member M-05509 / Atlas Tech Group / 2026. Notices, threshold events, filing records, reimbursement, and activity stay scoped to this member within the group.
Submission-level view for carrier, client, or internal status questions.
| Submission | Paid period | Requested | Reimbursed | Outstanding | Status |
|---|---|---|---|---|---|
| Submission 2 SL-2026-0072-F02 / Supplemental filing | Mar 29, 2026 to May 22, 2026 | $0 | $0 | $0 | Watching |
| Submission 1 SL-2026-0072-F01 / Initial filing | Jan 1, 2026 to Mar 28, 2026 | $70,000 | $50,000 | $20,000 | Partial reimbursement |
| Total | $70,000 | $50,000 | $20,000 | ||
Current stop-loss position for this member in this group and policy year.
Voya Financial
approved
No daily notice row
One member can have one 50% notice event and multiple independent filing records after spec is crossed.
Estimated from current paid claims against $125,000 specific deductible.
Member entered the year-end and pre-spec monitoring lane.
$195,000 paid against $125,000 deductible.
SL-2026-0072-F01, filed amount $70,000.
$50,000 reimbursed against SL-2026-0072-F01.
SL-2026-0072-F02, $0 new eligible paid against $1,000 threshold.
Daily notices are one-time carrier notices. Older rows remain here as audit history.
Each filing is separate. Subsequent filings compare new eligible paid claims against the configured filing creation threshold.
Future treatment would open as a separate filing once new eligible paid claims meet the configured filing creation threshold.
Initial filing is still open: carrier reimbursed part of the request and the remaining dollars need denial/more-info follow-up. New filings still start after this filing’s cumulative paid amount.
Paid claim lines that feed notice percentages and filing packets.
| Date | Provider | Dx | Case | Amount |
|---|---|---|---|---|
| Feb 6, 2026 | Cleveland Clinic — Bone Marrow Clinic | C92.00 | SL-2026-0072 | $29,250 |
| Dec 28, 2025 | Walgreens Specialty Rx | C92.00 | SL-2026-0072 | $23,400 |
| Nov 23, 2025 | Cleveland Clinic — Outpatient | C92.00 | SL-2026-0072 | $35,100 |
| Nov 8, 2025 | Cleveland Clinic — Main | C92.00 | SL-2026-0072 | $107,250 |
System, rep, carrier, notice, and filing events in one history.
System pulled comparable surgical-fee data from prior approved cases at same facility
$50K paid against the $70K filed; $20K denied citing UCR review on surgical fees
Carrier flagged $20K of surgical fees for UCR (usual, customary, reasonable) review
SL-2026-0072-F01 for $70,000