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 B01M000708›AMARA VARGAS

AMARA VARGAS

Dependent on policy B01M000708

Claims
1
Attributed to this person
Charged
228.00
Total submitted
Denied
228.00
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
NameAMARA VARGAS
Role on the policyDependent · relationship 01
PolicyB01M000708
Date of birth21 Aug 2010
PlanGOLD PPO
Covered from7 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000315715 Jan 2025228.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY228.00