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 B10M000256›WENDY USMAN

WENDY USMAN

Dependent on policy B10M000256

Claims
1
Attributed to this person
Charged
857.00
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
NameWENDY USMAN
Role on the policyDependent · relationship 19
PolicyB10M000256
Date of birth7 May 2020
PlanPLATINUM PPO
Covered from12 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000105013 Jul 2024857.00MERIDIAN HEALTH PLANNot denied—