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 B08M000353›OMAR MURPHY

OMAR MURPHY

Dependent on policy B08M000353

Claims
1
Attributed to this person
Charged
298.00
Total submitted
Denied
298.00
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
NameOMAR MURPHY
Role on the policyDependent · relationship 19
PolicyB08M000353
Date of birth2 Nov 1998
PlanGOLD PPO
Covered from28 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000162323 Sep 2024298.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY298.00