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 B09M000035›GRACE BAKER

GRACE BAKER

Subscriber on policy B09M000035

Claims
3
Attributed to this person
Charged
1,837.00
Total submitted
Denied
1,212.00
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
NameGRACE BAKER
Role on the policySubscriber
PolicyB09M000035
Date of birth19 Jan 1954
PlanSILVER HMO
Covered from16 Dec 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000016528 Mar 2026625.00MERIDIAN HEALTH PLANNot denied—
CLM000016723 Dec 2025610.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION610.00
CLM000016614 Aug 2025602.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY602.00