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 B08M000637›TOMAS BAKER

TOMAS BAKER

Dependent on policy B08M000637

Claims
1
Attributed to this person
Charged
366.00
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
NameTOMAS BAKER
Role on the policyDependent · relationship 01
PolicyB08M000637
Date of birth17 Apr 1966
PlanSILVER HMO
Covered from5 Jun 2025
Covered to27 Aug 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000289224 May 2025366.00CASCADE CARENot denied—