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 B08M000259›PRIYA USMAN

PRIYA USMAN

Dependent on policy B08M000259

Claims
3
Attributed to this person
Charged
1,178.00
Total submitted
Denied
601.00
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
NamePRIYA USMAN
Role on the policyDependent · relationship 19
PolicyB08M000259
Date of birth24 Oct 2014
PlanPLATINUM PPO
Covered from26 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000117522 Mar 2026391.00NORTHSTAR MUTUALNot denied—
CLM000117712 Oct 2024186.00NORTHSTAR MUTUALNot denied—
CLM00011765 Apr 2024601.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY601.00