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Maya ThompsonPatient
DENIEDCase NS-PA-48291

MRI — Right Knee

Northstar Health

Requested by Dr. Emily Carter Requested on August 4, 2026

APPEAL DEADLINE

October 29, 202662 days remainingReview before this date.

One item needs your confirmation

We found records showing 7 weeks of physical therapy. Please confirm the start and end dates.

WHAT THE INSURER SAID — AND WHAT IT MEANS

Denial explanation

INSURER LANGUAGE (ORIGINAL)

“Documentation did not establish six weeks of physician-directed conservative treatment.”
Reason code
DOC-214
Source
Insurer denial

EXPLANATION IN PLAIN LANGUAGE

Northstar Health needs records showing that you completed at least six weeks of treatment—such as physical therapy—under a physician’s direction before approving the MRI.

Source
ASSERA explanation

AVAILABLE EVIDENCE

4 documents

DocumentSourceDateStatus
Orthopedic EvaluationPenn OrthopedicsAug 6, 2026Verified
Physical Therapy SummaryKeystone PTAug 20, 2026Needs confirmation
Knee X-Ray ReportNorthstar ImagingJul 29, 2026Verified
Denial NoticeNorthstar HealthAug 25, 2026Insurer source

APPEAL READINESS

4 of 5 requirements complete

  1. Physician evaluation
  2. Prior knee X-ray
  3. Six weeks of physician-directed conservative treatment
  4. Persistent symptoms after conservative treatment
  5. Treatment dates need confirmation

Administrative requirements from a fictional Northstar Health policy used for this synthetic demonstration.

INFORMATION NEEDED

Treatment dates need confirmation

Confirm the physical-therapy start and end dates to finish the administrative readiness check.

ASSERA is a demonstration of healthcare access navigation. It does not provide medical or legal advice.