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 B09M000281›AMARA CHEN

AMARA CHEN

Dependent on policy B09M000281

Claims
2
Attributed to this person
Charged
946.00
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
NameAMARA CHEN
Role on the policyDependent · relationship 01
PolicyB09M000281
Date of birth4 May 1992
PlanGOLD PPO
Covered from24 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00011552 Feb 2025270.00NORTHSTAR MUTUALNot denied—
CLM00011542 Dec 2024676.00NORTHSTAR MUTUALNot denied—