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 B07M000514›DAVID TANAKA

DAVID TANAKA

Dependent on policy B07M000514

Claims
3
Attributed to this person
Charged
1,044.00
Total submitted
Denied
966.00
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
NameDAVID TANAKA
Role on the policyDependent · relationship 01
PolicyB07M000514
Date of birth25 Oct 1974
PlanBRONZE EPO
Covered from6 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00021956 Jun 2026520.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY520.00
CLM000219417 Oct 202478.00MERIDIAN HEALTH PLANNot denied—
CLM00021969 Jul 2024446.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING446.00