DenialIntel

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 B08M000670›HENRY IQBAL

HENRY IQBAL

Dependent on policy B08M000670

Claims
2
Attributed to this person
Charged
579.00
Total submitted
Denied
406.00
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
NameHENRY IQBAL
Role on the policyDependent · relationship 19
PolicyB08M000670
Date of birth10 Oct 1992
PlanSILVER HMO
Covered from23 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000302217 Jul 2024406.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION406.00
CLM000302327 Mar 2024173.00MERIDIAN HEALTH PLANNot denied—