X12 Ingest & Denial Analytics

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 B01M000252›MARCUS ANDERSON

MARCUS ANDERSON

Subscriber on policy B01M000252

Claims
3
Attributed to this person
Charged
1,304.00
Total submitted
Denied
41.97
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
NameMARCUS ANDERSON
Role on the policySubscriber
PolicyB01M000252
Date of birth28 Mar 1998
PlanGOLD PPO
Covered from30 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000106913 Mar 2026804.00MERIDIAN HEALTH PLANNot denied—
CLM000107126 Nov 2024321.00MERIDIAN HEALTH PLANNot denied—
CLM00010705 Nov 2024179.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION41.97