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 B08M000058›OMAR FOSTER

OMAR FOSTER

Dependent on policy B08M000058

Claims
1
Attributed to this person
Charged
69.00
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
NameOMAR FOSTER
Role on the policyDependent · relationship 19
PolicyB08M000058
Date of birth28 Sep 2021
PlanGOLD PPO
Covered from9 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000026719 Jun 202569.00MERIDIAN HEALTH PLANNot denied—