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 B01M000219›WENDY SMITH

WENDY SMITH

Subscriber on policy B01M000219

Claims
2
Attributed to this person
Charged
1,179.00
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
NameWENDY SMITH
Role on the policySubscriber
PolicyB01M000219
Date of birth5 Mar 1970
PlanPLATINUM PPO
Covered from6 Jun 2024
Covered to6 Aug 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000093125 Aug 2024731.00MERIDIAN HEALTH PLANNot denied—
CLM000093215 Aug 2024448.00MERIDIAN HEALTH PLANNot denied—