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 B02M000229›RAVI VARGAS

RAVI VARGAS

Dependent on policy B02M000229

Claims
3
Attributed to this person
Charged
1,269.00
Total submitted
Denied
236.00
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 — 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
NameRAVI VARGAS
Role on the policyDependent · relationship 01
PolicyB02M000229
Date of birth6 Sep 1956
PlanPLATINUM PPO
Covered from2 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000100018 Aug 2026262.00NORTHSTAR MUTUALNot denied—
CLM00009998 Aug 2026771.00NORTHSTAR MUTUALNot denied—
CLM000100127 Sep 2025236.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY236.00