X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B02M000052›JULIA HUGHES

JULIA HUGHES

Subscriber on policy B02M000052

Claims
1
Attributed to this person
Charged
543.00
Total submitted
Denied
543.00
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 โ€” 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
NameJULIA HUGHES
Role on the policySubscriber
PolicyB02M000052
Date of birth6 Oct 1967
PlanPLATINUM PPO
Covered from9 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000024531 Oct 2024543.00MERIDIAN HEALTH PLANCARC 29 ยท TIMELY_FILING543.00