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 B02M000199›YUSUF WILSON

YUSUF WILSON

Dependent on policy B02M000199

Claims
3
Attributed to this person
Charged
1,451.00
Total submitted
Denied
1,318.00
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 WILSON
Role on the policyDependent · relationship 01
PolicyB02M000199
Date of birth4 Feb 2014
PlanSILVER HMO
Covered from1 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00008779 Jul 2026842.00NORTHSTAR MUTUALCARC 18 · DUPLICATE842.00
CLM00008789 Jul 2026133.00NORTHSTAR MUTUALNot denied—
CLM000087629 Oct 2025476.00NORTHSTAR MUTUALCARC 18 · DUPLICATE476.00