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 B02M000433›ELENA ANDERSON

ELENA ANDERSON

Subscriber on policy B02M000433

Claims
2
Attributed to this person
Charged
676.00
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 ANDERSON
Role on the policySubscriber
PolicyB02M000433
Date of birth12 May 1995
PlanBRONZE EPO
Covered from2 Mar 2024
Covered to29 May 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000184429 May 2024424.00MERIDIAN HEALTH PLANNot denied—
CLM000184519 Apr 2024252.00MERIDIAN HEALTH PLANNot denied—