X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B08M000450›MARCUS PATEL

MARCUS PATEL

Subscriber on policy B08M000450

Claims
1
Attributed to this person
Charged
535.00
Total submitted
Denied
535.00
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 โ€” 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
NameMARCUS PATEL
Role on the policySubscriber
PolicyB08M000450
Date of birth22 Sep 1987
PlanBRONZE EPO
Covered from5 Sep 2024
Covered to23 Feb 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000207717 Nov 2024535.00MERIDIAN HEALTH PLANCARC 29 ยท TIMELY_FILING535.00