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 B07M000026›GRACE HUGHES

GRACE HUGHES

Subscriber on policy B07M000026

Claims
2
Attributed to this person
Charged
1,087.00
Total submitted
Denied
320.00
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
NameGRACE HUGHES
Role on the policySubscriber
PolicyB07M000026
Date of birth17 Feb 1960
PlanBRONZE EPO
Covered from26 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000011630 Mar 2025320.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE320.00
CLM000011515 Aug 2024767.00MERIDIAN HEALTH PLANNot denied—