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 B10M000303›BRIAN REYES

BRIAN REYES

Dependent on policy B10M000303

Claims
2
Attributed to this person
Charged
1,452.00
Total submitted
Denied
570.00
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
NameBRIAN REYES
Role on the policyDependent · relationship 19
PolicyB10M000303
Date of birth2 Aug 1993
PlanGOLD PPO
Covered from28 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00012724 Jul 2026882.00MERIDIAN HEALTH PLANNot denied—
CLM000127120 Jul 2025570.00MERIDIAN HEALTH PLANCARC 11 · CODING570.00