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 B01M000215›JULIA ANDERSON

JULIA ANDERSON

Subscriber on policy B01M000215

Claims
3
Attributed to this person
Charged
654.00
Total submitted
Denied
654.00
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
NameJULIA ANDERSON
Role on the policySubscriber
PolicyB01M000215
Date of birth17 Apr 1995
PlanSILVER HMO
Covered from22 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000091519 Jun 2025310.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING310.00
CLM000091715 Feb 2025230.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE230.00
CLM000091628 Oct 2024114.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING114.00