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 B08M000117›TOMAS MURPHY

TOMAS MURPHY

Dependent on policy B08M000117

Claims
2
Attributed to this person
Charged
1,159.00
Total submitted
Denied
422.00
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
NameTOMAS MURPHY
Role on the policyDependent · relationship 01
PolicyB08M000117
Date of birth17 Dec 1970
PlanSILVER HMO
Covered from25 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000052122 Mar 2026737.00NORTHSTAR MUTUALNot denied—
CLM000052024 Feb 2025422.00NORTHSTAR MUTUALCARC 197 · AUTHORIZATION422.00