X12 Ingest & Denial Analytics

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 B09M000117›BRIAN ANDERSON

BRIAN ANDERSON

Dependent on policy B09M000117

Claims
2
Attributed to this person
Charged
1,123.00
Total submitted
Denied
414.00
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
NameBRIAN ANDERSON
Role on the policyDependent · relationship 01
PolicyB09M000117
Date of birth13 Nov 1965
PlanSILVER HMO
Covered from28 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000048214 Apr 2025414.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING414.00
CLM000048113 Jan 2025709.00MERIDIAN HEALTH PLANNot denied—