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 B08M000278›WENDY PATEL

WENDY PATEL

Dependent on policy B08M000278

Claims
3
Attributed to this person
Charged
1,444.00
Total submitted
Denied
487.00
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 PATEL
Role on the policyDependent · relationship 01
PolicyB08M000278
Date of birth30 Mar 2002
PlanSILVER HMO
Covered from5 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00012668 Feb 2026681.00MERIDIAN HEALTH PLANNot denied—
CLM000126731 Mar 2025487.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE487.00
CLM00012653 Dec 2024276.00MERIDIAN HEALTH PLANNot denied—