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 B09M000477›JULIA MURPHY

JULIA MURPHY

Dependent on policy B09M000477

Claims
3
Attributed to this person
Charged
671.00
Total submitted
Denied
315.00
3 denied claims
Patient responsibility
231.40
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
NameJULIA MURPHY
Role on the policyDependent · relationship 01
PolicyB09M000477
Date of birth3 Sep 1980
PlanSILVER HMO
Covered from28 May 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 50 · Other1231.40
Total231.40

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00020155 Jul 202662.00MERIDIAN HEALTH PLANCARC 11 · CODING62.00
CLM00020178 May 2026356.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY0.00
CLM000201626 Jul 2025253.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE253.00