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 B01M000311›YUSUF CHEN

YUSUF CHEN

Subscriber on policy B01M000311

Claims
2
Attributed to this person
Charged
1,247.00
Total submitted
Denied
1,247.00
2 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
NameYUSUF CHEN
Role on the policySubscriber
PolicyB01M000311
Date of birth16 Sep 1994
PlanPLATINUM PPO
Covered from6 Jan 2024
Covered to31 Aug 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000138418 Sep 2024595.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY595.00
CLM000138313 Jul 2024652.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING652.00