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 B02M000403›GRACE HUGHES

GRACE HUGHES

Dependent on policy B02M000403

Claims
1
Attributed to this person
Charged
615.00
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
NameGRACE HUGHES
Role on the policyDependent · relationship 19
PolicyB02M000403
Date of birth21 Mar 2016
PlanBRONZE EPO
Covered from13 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000173626 Jul 2026615.00NORTHSTAR MUTUALNot denied—