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 B08M000020›KEVIN PATEL

KEVIN PATEL

Dependent on policy B08M000020

Claims
1
Attributed to this person
Charged
74.00
Total submitted
Denied
74.00
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
NameKEVIN PATEL
Role on the policyDependent · relationship 19
PolicyB08M000020
Date of birth25 Mar 2008
PlanBRONZE EPO
Covered from10 Sep 2024
Covered to15 May 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000009028 Jun 202574.00CASCADE CARECARC 27 · ELIGIBILITY74.00