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 B09M000144›DAVID QUINN

DAVID QUINN

Dependent on policy B09M000144

Claims
1
Attributed to this person
Charged
670.00
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
NameDAVID QUINN
Role on the policyDependent · relationship 01
PolicyB09M000144
Date of birth30 Apr 2011
PlanSILVER HMO
Covered from17 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000060731 Dec 2024670.00MERIDIAN HEALTH PLANNot denied—