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 B09M000322›NADIA PATEL

NADIA PATEL

Subscriber on policy B09M000322

Claims
3
Attributed to this person
Charged
791.00
Total submitted
Denied
791.00
3 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
NameNADIA PATEL
Role on the policySubscriber
PolicyB09M000322
Date of birth18 Sep 1986
PlanPLATINUM PPO
Covered from13 Jul 2024
Covered to7 Nov 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000133026 Dec 2024136.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY136.00
CLM000133223 Dec 2024102.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY102.00
CLM000133119 Oct 2024553.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY553.00