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.

IVAN CHEN

Dependent on policy B08M000195

Claims
1
Attributed to this person
Charged
106.00
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
NameIVAN CHEN
Role on the policyDependent · relationship 19
PolicyB08M000195
Date of birth18 Oct 2012
PlanBRONZE EPO
Covered from6 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000087311 Mar 2026106.00NORTHSTAR MUTUALNot denied—