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 B10M000712›FIONA WILSON

FIONA WILSON

Dependent on policy B10M000712

Claims
2
Attributed to this person
Charged
253.00
Total submitted
Denied
135.00
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
NameFIONA WILSON
Role on the policyDependent · relationship 01
PolicyB10M000712
Date of birth6 May 1979
PlanSILVER HMO
Covered from25 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000298928 Nov 2025118.00MERIDIAN HEALTH PLANNot denied—
CLM00029872 Jan 2025135.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY135.00