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 B10M000862›WENDY QUINN

WENDY QUINN

Dependent on policy B10M000862

Claims
1
Attributed to this person
Charged
607.00
Total submitted
Denied
607.00
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
NameWENDY QUINN
Role on the policyDependent · relationship 19
PolicyB10M000862
Date of birth7 Nov 1988
PlanSILVER HMO
Covered from13 Aug 2024
Covered to21 Mar 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000365923 Apr 2025607.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY607.00