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 B09M000433›FIONA REYES

FIONA REYES

Subscriber on policy B09M000433

Claims
1
Attributed to this person
Charged
467.00
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
NameFIONA REYES
Role on the policySubscriber
PolicyB09M000433
Date of birth19 Aug 1996
PlanSILVER HMO
Covered from19 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000181325 Jul 2026467.00MERIDIAN HEALTH PLANNot denied—