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 B01M000232›FIONA JOHNSON

FIONA JOHNSON

Dependent on policy B01M000232

Claims
1
Attributed to this person
Charged
97.00
Total submitted
Denied
97.00
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
NameFIONA JOHNSON
Role on the policyDependent · relationship 01
PolicyB01M000232
Date of birth11 Jul 1986
PlanGOLD PPO
Covered from13 Oct 2024
Covered to13 Dec 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000098110 Feb 202597.00CASCADE CARECARC 27 · ELIGIBILITY97.00