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 B08M000239›ZARA SMITH

ZARA SMITH

Subscriber on policy B08M000239

Claims
2
Attributed to this person
Charged
965.00
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
NameZARA SMITH
Role on the policySubscriber
PolicyB08M000239
Date of birth3 Jun 1987
PlanSILVER HMO
Covered from1 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000107819 Apr 2025175.00MERIDIAN HEALTH PLANNot denied—
CLM00010798 Mar 2025790.00MERIDIAN HEALTH PLANNot denied—