DenialIntel

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B06M000359›HENRY YAMADA

HENRY YAMADA

Subscriber on policy B06M000359

Claims
1
Attributed to this person
Charged
765.00
Total submitted
Denied
765.00
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 โ€” 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
NameHENRY YAMADA
Role on the policySubscriber
PolicyB06M000359
Date of birth15 Feb 1993
PlanBRONZE EPO
Covered from22 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000163931 May 2026765.00NORTHSTAR MUTUALCARC 16 ยท BILLING_ERROR765.00