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 B08M000001›ZARA REYES

ZARA REYES

Subscriber on policy B08M000001

Claims
1
Attributed to this person
Charged
375.00
Total submitted
Denied
0.00
0 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
NameZARA REYES
Role on the policySubscriber
PolicyB08M000001
Date of birth9 Nov 1962
PlanSILVER HMO
Covered from15 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000000727 Jun 2026375.00NORTHSTAR MUTUALNot denied—