DenialIntel

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 B09M000453›ELENA QUINN

ELENA QUINN

Dependent on policy B09M000453

Claims
2
Attributed to this person
Charged
635.00
Total submitted
Denied
635.00
2 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 QUINN
Role on the policyDependent · relationship 01
PolicyB09M000453
Date of birth26 Mar 1959
PlanBRONZE EPO
Covered from16 Apr 2025
Covered to1 Dec 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00019044 Nov 202563.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE63.00
CLM000190318 Mar 2025572.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY572.00