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 B01M000830›MARCUS GARCIA

MARCUS GARCIA

Dependent on policy B01M000830

Claims
1
Attributed to this person
Charged
652.00
Total submitted
Denied
304.95
1 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
NameMARCUS GARCIA
Role on the policyDependent · relationship 01
PolicyB01M000830
Date of birth6 Mar 1966
PlanSILVER HMO
Covered from16 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000368521 Feb 2026652.00NORTHSTAR MUTUALCARC 29 · TIMELY_FILING304.95