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 B01M000009›DAVID CHEN

DAVID CHEN

Dependent on policy B01M000009

Claims
1
Attributed to this person
Charged
544.00
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
NameDAVID CHEN
Role on the policyDependent · relationship 01
PolicyB01M000009
Date of birth16 Dec 1970
PlanGOLD PPO
Covered from27 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000003421 Jul 2026544.00MERIDIAN HEALTH PLANNot denied—