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 B07M000233›GRACE QUINN

GRACE QUINN

Dependent on policy B07M000233

Claims
3
Attributed to this person
Charged
1,715.00
Total submitted
Denied
913.00
2 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 QUINN
Role on the policyDependent · relationship 01
PolicyB07M000233
Date of birth25 Aug 1951
PlanBRONZE EPO
Covered from15 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00009889 Jun 2026802.00MERIDIAN HEALTH PLANNot denied—
CLM000098910 Mar 2025716.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY716.00
CLM000098718 Feb 2025197.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY197.00