B-26-0429April batch · payer F840 + G809
96 claims · 12 participants · service period Apr 1–28, 2026
Cycle deadline May 1 — 2 days
Last submitted B-26-0418 · paid Apr 26
3 holds need review
✓
Assemble96 claims pulled from grid
2
Validate3 holds · clear or override
3
Reviewfinal batch totals
4
SubmitEDI 837 to MQD
Claims
96
12 participants
Service period
Apr 1–28
28 days · partial month
Gross billable
$18,977
1,486 units total
On hold
3
$386 at risk
Will submit
93
$18,591 net
!
Aguilar, Phillip · April cap exceeded by 12u on T2021
Monthly cap 240u. Logged 252u. Variance form required by Apr 30 to bill the +12u or those units will be denied.
!
Kahale, Noelani · Caregiver L. Mariano CPR cert expired Apr 14
3 visits (Apr 16, 19, 22) by uncertified caregiver. MQD will deny — reassign or hold.
!
Domingo, Ferdinand · EVV signature missing on Apr 22 visit
28u logged but no signature in app. F840 requires EVV — claim will be rejected at intake.
▲
Espinoza, Vidalia · Auth H2014 expires May 8 — 3 visits scheduled past expiry
Renewal packet not yet submitted to G809. Won't block this batch but next cycle will fail.
✓
93 of 96 claims passed all checks
EVV present · auth coverage verified · daily caps within tolerance · caregiver creds current.
$18,591 ready
02
Claims · 96
group:
show:
| Participant | Code | Caregiver | Visits | Units | Billable | Status | |
|---|---|---|---|---|---|---|---|
| ⚠ on hold · 3 issues blocking submission | |||||||
| ✕ | PA Aguilar, Phillip | T2021 | K. Pō · L. Mariano | 8 | 252 | $3,220.56 | cap +12u |
| ✕ | NK Kahale, Noelani | T2021 | 7 (3 held) | 186 | $2,377.08 | cred expired | |
| ✕ | FD Domingo, Ferdinand | T2021 | M. Kanaka | 6 (1 held) | 168 | $2,147.04 | no EVV |
| ✓ ready to submit · 9 of 9 shown | |||||||
| ✓ | MC Chen, Marisol | H2021 S5125 | K. Pō | 8 | 192 | $2,453.76 | ready |
| ✓ | VE Espinoza, Vidalia | H2014 S5125 | L. Mariano · M. Kanaka | 9 | 168 | $2,147.04 | renewal due |
| ✓ | LR Reyes, Lokelani | T2021 | K. Pō | 8 | 156 | $1,993.68 | ready |
| ✓ | JL Lui, Jonah | H2021 S5125 +1 | M. Kanaka | 7 | 142 | $1,814.76 | ready |
| ✓ | KM Manaia, Keoki | H2021 S5150 | L. Mariano | 8 | 128 | $1,635.84 | ready |
| ✓ | SI Iaea, Solomon | H2021 S5150 | K. Pō | 7 | 112 | $1,431.36 | ready |
| ✓ | TK Kalua, Tehani | T2021 | L. Mariano | 7 | 98 | $1,252.44 | ready |
| ✓ | MN Nakamura, Mahina | T2021 | K. Pō | 6 | 84 | $1,073.52 | ready |
| ✓ | DH Hokulani, Daniel | H2021 T2021 | M. Kanaka · L. Mariano | 6 | 72 | $919.68 | ready |
Showing 12 participants · 96 claim lines collapsed · expand all →
ABatch summary
93 ready · $18,591
3 on hold · $386
0 deferred
Gross billable$18,977.04
Held back−$386.04
Variance recovery+$0.00
Net submission$18,591.00
BRouting
Payer split · F84052 claims · $10,108
Payer split · G80941 claims · $8,483
FormatEDI 837 v5010
ClearinghouseAvaility
Expected ack≤24h
Submit batch
93 claims · $18,591 · routed to F840 + G809 via Availity
Or override holds (logged in audit trail)
After submission:
• Each claim gets a state of submitted in the grid
• Acknowledgment expected within 24h (835 ERA)
• Audit log entry on every linked auth
• Held claims roll into next cycle once resolved
• Each claim gets a state of submitted in the grid
• Acknowledgment expected within 24h (835 ERA)
• Audit log entry on every linked auth
• Held claims roll into next cycle once resolved