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 B07M000251›PRIYA WILSON

PRIYA WILSON

Dependent on policy B07M000251

Claims
1
Attributed to this person
Charged
436.00
Total submitted
Denied
436.00
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
NamePRIYA WILSON
Role on the policyDependent · relationship 01
PolicyB07M000251
Date of birth8 Nov 1961
PlanBRONZE EPO
Covered from9 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000107025 Apr 2026436.00NORTHSTAR MUTUALCARC 11 · CODING436.00