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 B10M000240›TOMAS NGUYEN

TOMAS NGUYEN

Subscriber on policy B10M000240

Claims
3
Attributed to this person
Charged
2,366.00
Total submitted
Denied
850.00
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
NameTOMAS NGUYEN
Role on the policySubscriber
PolicyB10M000240
Date of birth24 Jul 1979
PlanBRONZE EPO
Covered from18 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000098520 Aug 2026671.00NORTHSTAR MUTUALNot denied—
CLM00009834 Jul 2026845.00NORTHSTAR MUTUALNot denied—
CLM000098413 Jun 2025850.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY850.00