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 B02M000119›ELENA HUGHES

ELENA HUGHES

Dependent on policy B02M000119

Claims
2
Attributed to this person
Charged
1,497.00
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
NameELENA HUGHES
Role on the policyDependent · relationship 01
PolicyB02M000119
Date of birth6 Aug 1996
PlanGOLD PPO
Covered from2 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000054320 Jul 2026837.00MERIDIAN HEALTH PLANNot denied—
CLM00005424 Oct 2024660.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY660.00