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 B02M000048›ELENA QUINN

ELENA QUINN

Dependent on policy B02M000048

Claims
2
Attributed to this person
Charged
1,188.00
Total submitted
Denied
0.00
0 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
NameELENA QUINN
Role on the policyDependent · relationship 19
PolicyB02M000048
Date of birth30 Jun 1993
PlanBRONZE EPO
Covered from11 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00002346 Aug 2026318.00MERIDIAN HEALTH PLANNot denied—
CLM00002351 Jul 2025870.00MERIDIAN HEALTH PLANNot denied—