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 B06M000792›WENDY VARGAS

WENDY VARGAS

Dependent on policy B06M000792

Claims
1
Attributed to this person
Charged
823.00
Total submitted
Denied
823.00
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 — 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
NameWENDY VARGAS
Role on the policyDependent · relationship 01
PolicyB06M000792
Date of birth14 Apr 1973
PlanSILVER HMO
Covered from20 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00034885 Jan 2026823.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY823.00