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 B10M000204›RAVI PATEL

RAVI PATEL

Dependent on policy B10M000204

Claims
1
Attributed to this person
Charged
660.00
Total submitted
Denied
660.00
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
NameRAVI PATEL
Role on the policyDependent · relationship 01
PolicyB10M000204
Date of birth14 Feb 1989
PlanBRONZE EPO
Covered from16 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000084122 May 2026660.00CASCADE CARECARC 27 · ELIGIBILITY660.00