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 B07M000317›KEVIN EVANS

KEVIN EVANS

Dependent on policy B07M000317

Claims
2
Attributed to this person
Charged
941.00
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
NameKEVIN EVANS
Role on the policyDependent · relationship 01
PolicyB07M000317
Date of birth13 Dec 1945
PlanPLATINUM PPO
Covered from8 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000137124 Jun 2025189.00NORTHSTAR MUTUALNot denied—
CLM00013709 Jan 2025752.00NORTHSTAR MUTUALNot denied—