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 B07M000635›ELENA REYES

ELENA REYES

Subscriber on policy B07M000635

Claims
2
Attributed to this person
Charged
1,000.00
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
NameELENA REYES
Role on the policySubscriber
PolicyB07M000635
Date of birth21 Nov 1996
PlanPLATINUM PPO
Covered from7 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000265423 Aug 2026843.00NORTHSTAR MUTUALNot denied—
CLM000265324 Apr 2026157.00NORTHSTAR MUTUALNot denied—