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 B10M000452›IVAN OKAFOR

IVAN OKAFOR

Subscriber on policy B10M000452

Claims
1
Attributed to this person
Charged
321.00
Total submitted
Denied
321.00
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
NameIVAN OKAFOR
Role on the policySubscriber
PolicyB10M000452
Date of birth16 Feb 1982
PlanBRONZE EPO
Covered from5 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000187125 May 2025321.00NORTHSTAR MUTUALCARC 26 ยท ELIGIBILITY321.00