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 B08M000888›JULIA USMAN

JULIA USMAN

Subscriber on policy B08M000888

Claims
2
Attributed to this person
Charged
1,529.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
126.20
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
NameJULIA USMAN
Role on the policySubscriber
PolicyB08M000888
Date of birth22 Dec 1954
PlanGOLD PPO
Covered from27 Jun 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 2 · Coinsurance1126.20
Total126.20

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000397524 Jul 2026898.00MERIDIAN HEALTH PLANNot denied—
CLM000397420 Feb 2025631.00MERIDIAN HEALTH PLANNot denied—