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 B01M000143›NADIA IQBAL

NADIA IQBAL

Subscriber on policy B01M000143

Claims
2
Attributed to this person
Charged
491.00
Total submitted
Denied
354.00
1 denied claims
Patient responsibility
50.00
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
NameNADIA IQBAL
Role on the policySubscriber
PolicyB01M000143
Date of birth16 Oct 1964
PlanGOLD PPO
Covered from29 Dec 2024
Covered to15 Oct 2025

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 3 · Copay150.00
Total50.00

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000059524 Sep 2025354.00CASCADE CARECARC 16 · BILLING_ERROR354.00
CLM000059424 Aug 2025137.00CASCADE CARENot denied—