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 B08M000573›LEILA SMITH

LEILA SMITH

Subscriber on policy B08M000573

Claims
3
Attributed to this person
Charged
1,334.00
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
NameLEILA SMITH
Role on the policySubscriber
PolicyB08M000573
Date of birth2 May 1992
PlanSILVER HMO
Covered from18 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000261725 Jun 2026803.00NORTHSTAR MUTUALNot denied—
CLM000261631 Dec 2025434.00NORTHSTAR MUTUALNot denied—
CLM000261812 Sep 202597.00NORTHSTAR MUTUALNot denied—