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 B09M000749›JULIA VARGAS

JULIA VARGAS

Dependent on policy B09M000749

Claims
3
Attributed to this person
Charged
2,051.00
Total submitted
Denied
650.00
1 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 VARGAS
Role on the policyDependent · relationship 19
PolicyB09M000749
Date of birth28 Oct 2009
PlanGOLD PPO
Covered from31 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000317531 Jul 2026874.00NORTHSTAR MUTUALNot denied—
CLM000317611 Sep 2025650.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY650.00
CLM000317716 Jul 2025527.00NORTHSTAR MUTUALNot denied—