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 B01M000159›TOMAS GARCIA

TOMAS GARCIA

Subscriber on policy B01M000159

Claims
1
Attributed to this person
Charged
431.00
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
NameTOMAS GARCIA
Role on the policySubscriber
PolicyB01M000159
Date of birth10 Nov 1973
PlanSILVER HMO
Covered from17 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00006819 Oct 2025431.00MERIDIAN HEALTH PLANNot denied—