DenialIntel

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 B06M000750›IVAN EVANS

IVAN EVANS

Subscriber on policy B06M000750

Claims
1
Attributed to this person
Charged
374.00
Total submitted
Denied
0.00
0 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
NameIVAN EVANS
Role on the policySubscriber
PolicyB06M000750
Date of birth10 Jul 1955
PlanGOLD PPO
Covered from16 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000333113 Apr 2026374.00MERIDIAN HEALTH PLANNot denied—