DenialIntel

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 B02M000227›HENRY TANAKA

HENRY TANAKA

Subscriber on policy B02M000227

Claims
1
Attributed to this person
Charged
74.00
Total submitted
Denied
74.00
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
NameHENRY TANAKA
Role on the policySubscriber
PolicyB02M000227
Date of birth13 Jul 1973
PlanGOLD PPO
Covered from25 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000098631 May 202574.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY74.00