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 B07M000703›BRIAN VARGAS

BRIAN VARGAS

Dependent on policy B07M000703

Claims
2
Attributed to this person
Charged
1,701.00
Total submitted
Denied
1,701.00
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
NameBRIAN VARGAS
Role on the policyDependent · relationship 19
PolicyB07M000703
Date of birth15 Jun 1970
PlanGOLD PPO
Covered from16 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000291222 Jul 2026814.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION814.00
CLM00029132 Aug 2025887.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING887.00