DenialIntel

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 B02M000176›JULIA EVANS

JULIA EVANS

Subscriber on policy B02M000176

Claims
2
Attributed to this person
Charged
1,288.00
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
NameJULIA EVANS
Role on the policySubscriber
PolicyB02M000176
Date of birth5 Jan 1975
PlanSILVER HMO
Covered from28 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000079018 May 2026680.00NORTHSTAR MUTUALNot denied—
CLM000079115 Feb 2026608.00NORTHSTAR MUTUALNot denied—