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 B02M000830›GRACE CHEN

GRACE CHEN

Subscriber on policy B02M000830

Claims
1
Attributed to this person
Charged
343.00
Total submitted
Denied
343.00
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
NameGRACE CHEN
Role on the policySubscriber
PolicyB02M000830
Date of birth12 May 1963
PlanPLATINUM PPO
Covered from21 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000345226 Jan 2025343.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY343.00