DenialIntel

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B10M000379›PRIYA EVANS

PRIYA EVANS

Subscriber on policy B10M000379

Claims
1
Attributed to this person
Charged
878.00
Total submitted
Denied
878.00
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 โ€” 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
NamePRIYA EVANS
Role on the policySubscriber
PolicyB10M000379
Date of birth30 Nov 1961
PlanBRONZE EPO
Covered from21 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00015739 Oct 2025878.00MERIDIAN HEALTH PLANCARC 16 ยท BILLING_ERROR878.00