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 B09M000757›OMAR KUMAR

OMAR KUMAR

Dependent on policy B09M000757

Claims
1
Attributed to this person
Charged
91.00
Total submitted
Denied
91.00
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
NameOMAR KUMAR
Role on the policyDependent · relationship 01
PolicyB09M000757
Date of birth7 May 1962
PlanBRONZE EPO
Covered from15 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00032022 Dec 202591.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY91.00