X12 Ingest & Denial Analytics

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B06M000747›LEILA ANDERSON

LEILA ANDERSON

Subscriber on policy B06M000747

Claims
3
Attributed to this person
Charged
1,820.00
Total submitted
Denied
914.29
3 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.

Who this is

FieldValue
NameLEILA ANDERSON
Role on the policySubscriber
PolicyB06M000747
Date of birth20 May 1991
PlanBRONZE EPO
Covered from4 Aug 2024
Covered to22 Dec 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000331228 Dec 2024518.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY518.00
CLM000331123 Sep 2024837.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY207.06
CLM000331020 Aug 2024465.00MERIDIAN HEALTH PLANCARC 11 · CODING189.23