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 B10M000691›SOFIA OKAFOR

SOFIA OKAFOR

Dependent on policy B10M000691

Claims
1
Attributed to this person
Charged
654.00
Total submitted
Denied
246.21
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
NameSOFIA OKAFOR
Role on the policyDependent · relationship 01
PolicyB10M000691
Date of birth3 Feb 1963
PlanSILVER HMO
Covered from15 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000288718 May 2026654.00NORTHSTAR MUTUALCARC 197 · AUTHORIZATION246.21