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 B09M000206›ELENA FOSTER

ELENA FOSTER

Subscriber on policy B09M000206

Claims
3
Attributed to this person
Charged
2,092.00
Total submitted
Denied
860.00
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
NameELENA FOSTER
Role on the policySubscriber
PolicyB09M000206
Date of birth19 Jan 1977
PlanPLATINUM PPO
Covered from16 Sep 2024
Covered to26 Nov 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000086631 Oct 2024860.00MERIDIAN HEALTH PLANCARC 11 · CODING860.00
CLM000086411 Oct 2024505.00MERIDIAN HEALTH PLANNot denied—
CLM00008659 Oct 2024727.00MERIDIAN HEALTH PLANNot denied—