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 B07M000002›BRIAN BAKER

BRIAN BAKER

Dependent on policy B07M000002

Claims
1
Attributed to this person
Charged
833.00
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
NameBRIAN BAKER
Role on the policyDependent · relationship 01
PolicyB07M000002
Date of birth10 Dec 1986
PlanGOLD PPO
Covered from5 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000001428 Sep 2025833.00MERIDIAN HEALTH PLANNot denied—