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 B07M000442›NADIA REYES

NADIA REYES

Dependent on policy B07M000442

Claims
1
Attributed to this person
Charged
189.00
Total submitted
Denied
189.00
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
NameNADIA REYES
Role on the policyDependent · relationship 19
PolicyB07M000442
Date of birth28 Jun 2014
PlanPLATINUM PPO
Covered from9 Dec 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000186924 Apr 2026189.00CASCADE CARECARC 197 · AUTHORIZATION189.00