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 B01M000138›LEILA KUMAR

LEILA KUMAR

Dependent on policy B01M000138

Claims
1
Attributed to this person
Charged
650.00
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
NameLEILA KUMAR
Role on the policyDependent · relationship 19
PolicyB01M000138
Date of birth8 May 2019
PlanPLATINUM PPO
Covered from26 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00005697 Apr 2025650.00MERIDIAN HEALTH PLANNot denied—