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.

UMA PATEL

Subscriber on policy B06M000579

Claims
1
Attributed to this person
Charged
105.00
Total submitted
Denied
105.00
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
NameUMA PATEL
Role on the policySubscriber
PolicyB06M000579
Date of birth1 Nov 1963
PlanBRONZE EPO
Covered from29 Dec 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000259713 Jan 2025105.00NORTHSTAR MUTUALCARC 29 ยท TIMELY_FILING105.00