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 B08M000820›RAVI BAKER

RAVI BAKER

Subscriber on policy B08M000820

Claims
1
Attributed to this person
Charged
827.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
537.55
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
NameRAVI BAKER
Role on the policySubscriber
PolicyB08M000820
Date of birth23 Aug 1992
PlanBRONZE EPO
Covered from8 Jan 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 50 · Other1537.55
Total537.55

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000366722 Nov 2025827.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY0.00