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 B10M000323›DAVID FOSTER

DAVID FOSTER

Dependent on policy B10M000323

Claims
2
Attributed to this person
Charged
293.00
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
NameDAVID FOSTER
Role on the policyDependent · relationship 19
PolicyB10M000323
Date of birth9 Sep 2009
PlanGOLD PPO
Covered from15 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000135918 Jul 202666.00MERIDIAN HEALTH PLANNot denied—
CLM00013601 Jan 2025227.00MERIDIAN HEALTH PLANNot denied—