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 B07M000233›MARCUS QUINN

MARCUS QUINN

Dependent on policy B07M000233

Claims
2
Attributed to this person
Charged
844.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
15.00
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
NameMARCUS QUINN
Role on the policyDependent · relationship 19
PolicyB07M000233
Date of birth21 Mar 1991
PlanBRONZE EPO
Covered from15 Mar 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 3 · Copay115.00
Total15.00

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000099023 Nov 2025486.00MERIDIAN HEALTH PLANNot denied—
CLM00009913 Nov 2025358.00MERIDIAN HEALTH PLANNot denied—