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.

UMA REYES

Subscriber on policy B06M000027

Claims
2
Attributed to this person
Charged
1,109.00
Total submitted
Denied
270.58
1 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
NameUMA REYES
Role on the policySubscriber
PolicyB06M000027
Date of birth8 Aug 1985
PlanPLATINUM PPO
Covered from4 Dec 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000016315 Apr 2026587.00NORTHSTAR MUTUALCARC 18 · DUPLICATE270.58
CLM00001644 Nov 2025522.00NORTHSTAR MUTUALNot denied—