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 B09M000076›KEVIN VARGAS

KEVIN VARGAS

Subscriber on policy B09M000076

Claims
3
Attributed to this person
Charged
1,110.00
Total submitted
Denied
74.00
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
NameKEVIN VARGAS
Role on the policySubscriber
PolicyB09M000076
Date of birth11 Nov 1968
PlanGOLD PPO
Covered from16 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000033423 Oct 202574.00CASCADE CARECARC 197 · AUTHORIZATION74.00
CLM00003366 Oct 2024289.00CASCADE CARENot denied—
CLM00003358 Aug 2024747.00CASCADE CARENot denied—