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 B10M000821›VICTOR USMAN

VICTOR USMAN

Subscriber on policy B10M000821

Claims
1
Attributed to this person
Charged
823.00
Total submitted
Denied
823.00
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
NameVICTOR USMAN
Role on the policySubscriber
PolicyB10M000821
Date of birth5 Jul 1973
PlanGOLD PPO
Covered from24 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000346719 Jul 2026823.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY823.00