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 B01M000347›UMA HUGHES

UMA HUGHES

Subscriber on policy B01M000347

Claims
3
Attributed to this person
Charged
1,420.00
Total submitted
Denied
1,420.00
3 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
NameUMA HUGHES
Role on the policySubscriber
PolicyB01M000347
Date of birth26 Jun 2003
PlanPLATINUM PPO
Covered from22 Jan 2024
Covered to2 Apr 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000152821 May 2024301.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY301.00
CLM00015279 Apr 2024783.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY783.00
CLM000152623 Dec 2023336.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY336.00