Pre-Bill Worklist
Coded encounters awaiting evidence-backed pre-bill review and human validation across CDI, coding, billing, and denial prevention queues.
Cases Pending Review
9
Open Opportunities
2
Claims at Risk
0
Cases Ready to Bill
2
| Case | Patient | Discharge | Facility | DRG | Payer | Charges | Opps | Top Opp Type | Denial Risk | Est. Impact | Readiness | Priority | Reviewer | Status | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ENC-2026-10272 Spine Fusion | PT-****7363 | May 22, 2026 | Metro Regional Hospital | 460 | Blue Cross Blue Shield | $88,400 | 1 | DRG Impact | Low | $11,240 | Ready for Billing Review | Low | J. Chen, CCS | Ready to Bill | |
ENC-2026-10260 Total Knee Replacement | PT-****7351 | May 20, 2026 | Metro Regional Hospital | 470 | Blue Cross Blue Shield | $48,250 | 1 | CC/MCC Opportunity | Low | $3,450 | Ready for Billing Review | Low | S. Bhatt, CDIP | Ready to Bill | |
ENC-2026-10250 Total Knee Replacement | PT-****7341 | May 30, 2026 | NorthStar Medical Center | 470 | Medicare | $48,250 | 0 | — | — | — | — | Medium | M. Alvarez, RN-CDIS | Needs Review | |
ENC-2026-10251 Total Hip Replacement | PT-****7342 | May 29, 2026 | Valley Orthopedic Institute | 470 | UnitedHealthcare | $52,900 | 0 | — | — | — | — | Medium | J. Chen, CCS | Needs Review | |
ENC-2026-10252 Spine Fusion | PT-****7343 | May 28, 2026 | Metro Regional Hospital | 460 | Aetna | $88,400 | 0 | — | — | — | — | Medium | P. Okafor, RHIA | Needs Review | |
ENC-2026-10253 Hip Fracture Repair | PT-****7344 | May 27, 2026 | Summit Surgical Hospital | 481 | Cigna | $41,250 | 0 | — | — | — | — | Medium | S. Bhatt, CDIP | Needs Review | |
ENC-2026-10254 Shoulder Arthroplasty | PT-****7345 | May 26, 2026 | NorthStar Medical Center | 483 | Blue Cross Blue Shield | $38,100 | 0 | — | — | — | — | High | L. Whitman, CCDS | In Review | |
ENC-2026-10255 Complex Fracture Repair | PT-****7346 | May 25, 2026 | Valley Orthopedic Institute | 492 | Humana | $46,800 | 0 | — | — | — | — | High | R. Iverson, CPC | In Review | |
ENC-2026-10256 Revision Joint Replacement | PT-****7347 | May 24, 2026 | Metro Regional Hospital | 467 | Medicare | $71,200 | 0 | — | — | — | — | High | Unassigned | In Review | |
ENC-2026-10257 Post-Operative Complication Case | PT-****7348 | May 23, 2026 | Summit Surgical Hospital | 470 | UnitedHealthcare | $59,750 | 0 | — | — | — | — | High | M. Alvarez, RN-CDIS | In Review | |
ENC-2026-10258 Inpatient Orthopedic Trauma Case | PT-****7349 | May 22, 2026 | NorthStar Medical Center | 536 | Aetna | $28,950 | 0 | — | — | — | — | High | J. Chen, CCS | In Review | |
ENC-2026-10259 Total Knee Replacement | PT-****7350 | May 21, 2026 | Valley Orthopedic Institute | 470 | Cigna | $47,100 | 0 | — | — | — | — | High | P. Okafor, RHIA | In Review | |
ENC-2026-10261 Total Hip Replacement | PT-****7352 | May 19, 2026 | Summit Surgical Hospital | 470 | Humana | $52,900 | 0 | — | — | — | — | Low | L. Whitman, CCDS | Closed / No Opportunity | |
ENC-2026-10262 Spine Fusion | PT-****7353 | May 18, 2026 | NorthStar Medical Center | 460 | Medicare | $88,400 | 0 | — | — | — | — | Low | R. Iverson, CPC | Closed / No Opportunity | |
ENC-2026-10263 Hip Fracture Repair | PT-****7354 | May 17, 2026 | Valley Orthopedic Institute | 481 | UnitedHealthcare | $41,250 | 0 | — | — | — | — | Low | Unassigned | Closed / No Opportunity | |
ENC-2026-10264 Shoulder Arthroplasty | PT-****7355 | May 30, 2026 | Metro Regional Hospital | 483 | Aetna | $38,100 | 0 | — | — | — | — | Medium | M. Alvarez, RN-CDIS | Needs Review | |
ENC-2026-10265 Complex Fracture Repair | PT-****7356 | May 29, 2026 | Summit Surgical Hospital | 492 | Cigna | $46,800 | 0 | — | — | — | — | Medium | J. Chen, CCS | Needs Review | |
ENC-2026-10266 Revision Joint Replacement | PT-****7357 | May 28, 2026 | NorthStar Medical Center | 467 | Blue Cross Blue Shield | $71,200 | 0 | — | — | — | — | High | P. Okafor, RHIA | In Review | |
ENC-2026-10267 Post-Operative Complication Case | PT-****7358 | May 27, 2026 | Valley Orthopedic Institute | 470 | Humana | $59,750 | 0 | — | — | — | — | High | S. Bhatt, CDIP | In Review | |
ENC-2026-10268 Inpatient Orthopedic Trauma Case | PT-****7359 | May 26, 2026 | Metro Regional Hospital | 536 | Medicare | $28,950 | 0 | — | — | — | — | Medium | L. Whitman, CCDS | Needs Review | |
ENC-2026-10269 Total Knee Replacement | PT-****7360 | May 25, 2026 | Summit Surgical Hospital | 470 | UnitedHealthcare | $47,100 | 0 | — | — | — | — | High | R. Iverson, CPC | In Review | |
ENC-2026-10270 Total Knee Replacement | PT-****7361 | May 24, 2026 | NorthStar Medical Center | 470 | Aetna | $48,250 | 0 | — | — | — | — | Medium | Unassigned | Needs Review | |
ENC-2026-10271 Total Hip Replacement | PT-****7362 | May 23, 2026 | Valley Orthopedic Institute | 470 | Cigna | $52,900 | 0 | — | — | — | — | Medium | M. Alvarez, RN-CDIS | Needs Review | |
ENC-2026-10273 Hip Fracture Repair | PT-****7364 | May 21, 2026 | Summit Surgical Hospital | 481 | Humana | $41,250 | 0 | — | — | — | — | High | P. Okafor, RHIA | In Review |