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.

OMAR CHEN

Dependent on policy B08M000737

Claims
3
Attributed to this person
Charged
2,298.00
Total submitted
Denied
1,414.00
2 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
NameOMAR CHEN
Role on the policyDependent · relationship 19
PolicyB08M000737
Date of birth5 May 1997
PlanGOLD PPO
Covered from13 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000330723 Jun 2025884.00CASCADE CARENot denied—
CLM000330511 Aug 2024713.00CASCADE CARECARC 29 · TIMELY_FILING713.00
CLM00033065 Aug 2024701.00CASCADE CARECARC 27 · ELIGIBILITY701.00