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 B10M000127›JULIA SMITH

JULIA SMITH

Subscriber on policy B10M000127

Claims
1
Attributed to this person
Charged
747.00
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
NameJULIA SMITH
Role on the policySubscriber
PolicyB10M000127
Date of birth21 Aug 1996
PlanGOLD PPO
Covered from17 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000053726 Aug 2026747.00MERIDIAN HEALTH PLANNot denied—