X12 Ingest & Denial Analytics

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 B08M000120›WENDY BAKER

WENDY BAKER

Subscriber on policy B08M000120

Claims
3
Attributed to this person
Charged
1,348.00
Total submitted
Denied
296.00
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
NameWENDY BAKER
Role on the policySubscriber
PolicyB08M000120
Date of birth2 Sep 1967
PlanPLATINUM PPO
Covered from7 Sep 2024
Covered to16 Apr 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000053328 Feb 2025159.00MERIDIAN HEALTH PLANNot denied—
CLM000053230 Sep 2024893.00MERIDIAN HEALTH PLANNot denied—
CLM00005349 Sep 2024296.00MERIDIAN HEALTH PLANCARC 11 · CODING296.00