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.

UMA QUINN

Dependent on policy B08M000415

Claims
3
Attributed to this person
Charged
875.00
Total submitted
Denied
141.00
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
NameUMA QUINN
Role on the policyDependent · relationship 01
PolicyB08M000415
Date of birth9 Apr 1981
PlanSILVER HMO
Covered from15 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000191425 Aug 2025280.00MERIDIAN HEALTH PLANNot denied—
CLM000191310 May 2025454.00MERIDIAN HEALTH PLANNot denied—
CLM000191516 Dec 2024141.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY141.00