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 B10M000370›HENRY NGUYEN

HENRY NGUYEN

Subscriber on policy B10M000370

Claims
1
Attributed to this person
Charged
495.00
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
NameHENRY NGUYEN
Role on the policySubscriber
PolicyB10M000370
Date of birth6 Nov 1976
PlanSILVER HMO
Covered from26 May 2024
Covered to16 Nov 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00015447 Sep 2024495.00MERIDIAN HEALTH PLANNot denied—