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.

UMA USMAN

Subscriber on policy B01M000331

Claims
1
Attributed to this person
Charged
131.00
Total submitted
Denied
131.00
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
NameUMA USMAN
Role on the policySubscriber
PolicyB01M000331
Date of birth1 Apr 1957
PlanPLATINUM PPO
Covered from3 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000146810 Dec 2024131.00MERIDIAN HEALTH PLANCARC 29 ยท TIMELY_FILING131.00