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 B07M000372›AMARA FOSTER

AMARA FOSTER

Dependent on policy B07M000372

Claims
1
Attributed to this person
Charged
281.00
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
NameAMARA FOSTER
Role on the policyDependent · relationship 19
PolicyB07M000372
Date of birth5 Jan 1996
PlanSILVER HMO
Covered from17 Jun 2024
Covered to2 Mar 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000159220 Jun 2024281.00MERIDIAN HEALTH PLANNot denied—