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 B09M000403›UMA HUGHES

UMA HUGHES

Dependent on policy B09M000403

Claims
3
Attributed to this person
Charged
524.00
Total submitted
Denied
524.00
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
NameUMA HUGHES
Role on the policyDependent · relationship 19
PolicyB09M000403
Date of birth6 Jun 2020
PlanPLATINUM PPO
Covered from30 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000167627 Apr 2025154.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING154.00
CLM000167526 Feb 202589.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING89.00
CLM000167415 Feb 2025281.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE281.00