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 B10M000117›LEILA PATEL

LEILA PATEL

Subscriber on policy B10M000117

Claims
3
Attributed to this person
Charged
895.00
Total submitted
Denied
42.82
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
NameLEILA PATEL
Role on the policySubscriber
PolicyB10M000117
Date of birth10 Aug 1969
PlanSILVER HMO
Covered from1 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004848 Aug 2026495.00CASCADE CARENot denied—
CLM00004869 Sep 2024289.00CASCADE CARENot denied—
CLM000048522 Jul 2024111.00CASCADE CARECARC 16 · BILLING_ERROR42.82