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 B10M000245›OMAR FOSTER

OMAR FOSTER

Dependent on policy B10M000245

Claims
3
Attributed to this person
Charged
1,404.00
Total submitted
Denied
0.00
0 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
NameOMAR FOSTER
Role on the policyDependent · relationship 01
PolicyB10M000245
Date of birth2 Jun 1951
PlanSILVER HMO
Covered from14 Aug 2024
Covered to14 May 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000100825 Jun 2025212.00NORTHSTAR MUTUALNot denied—
CLM00010092 Mar 2025813.00NORTHSTAR MUTUALNot denied—
CLM00010076 Nov 2024379.00NORTHSTAR MUTUALNot denied—