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 B07M000282›NADIA FOSTER

NADIA FOSTER

Dependent on policy B07M000282

Claims
2
Attributed to this person
Charged
1,342.00
Total submitted
Denied
918.53
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
NameNADIA FOSTER
Role on the policyDependent · relationship 19
PolicyB07M000282
Date of birth25 Jun 2019
PlanBRONZE EPO
Covered from19 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000122919 Jul 2026722.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY298.53
CLM000122826 Jul 2025620.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE620.00