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 B07M000265›PRIYA EVANS

PRIYA EVANS

Dependent on policy B07M000265

Claims
1
Attributed to this person
Charged
736.00
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
NamePRIYA EVANS
Role on the policyDependent · relationship 19
PolicyB07M000265
Date of birth8 Jan 2001
PlanPLATINUM PPO
Covered from20 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000113831 Dec 2024736.00MERIDIAN HEALTH PLANNot denied—