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 B09M000302›YUSUF ANDERSON

YUSUF ANDERSON

Subscriber on policy B09M000302

Claims
3
Attributed to this person
Charged
1,568.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
463.45
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
NameYUSUF ANDERSON
Role on the policySubscriber
PolicyB09M000302
Date of birth9 Aug 1985
PlanSILVER HMO
Covered from17 Jul 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 50 · Other1463.45
Total463.45

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00012445 Aug 2026716.00CASCADE CARENot denied—
CLM00012461 May 2025139.00CASCADE CARENot denied—
CLM000124515 Sep 2024713.00CASCADE CARECARC 50 · MEDICAL_NECESSITY0.00