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 B10M000156›ELENA QUINN

ELENA QUINN

Subscriber on policy B10M000156

Claims
1
Attributed to this person
Charged
821.00
Total submitted
Denied
821.00
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
NameELENA QUINN
Role on the policySubscriber
PolicyB10M000156
Date of birth19 Jan 1995
PlanGOLD PPO
Covered from18 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00006297 Feb 2025821.00NORTHSTAR MUTUALCARC 27 ยท ELIGIBILITY821.00