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 B08M000539›AMARA EVANS

AMARA EVANS

Dependent on policy B08M000539

Claims
3
Attributed to this person
Charged
1,255.00
Total submitted
Denied
753.00
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
NameAMARA EVANS
Role on the policyDependent · relationship 19
PolicyB08M000539
Date of birth8 Dec 1995
PlanBRONZE EPO
Covered from21 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000247831 Mar 2026234.00NORTHSTAR MUTUALNot denied—
CLM000247719 Oct 2025268.00NORTHSTAR MUTUALNot denied—
CLM000247613 Aug 2025753.00NORTHSTAR MUTUALCARC 96 · NON_COVERED753.00