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 B02M000529›BRIAN JOHNSON

BRIAN JOHNSON

Dependent on policy B02M000529

Claims
3
Attributed to this person
Charged
1,464.00
Total submitted
Denied
864.00
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
NameBRIAN JOHNSON
Role on the policyDependent · relationship 01
PolicyB02M000529
Date of birth15 May 1949
PlanBRONZE EPO
Covered from24 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000223729 Jul 2026600.00NORTHSTAR MUTUALNot denied—
CLM000223918 Nov 2025670.00NORTHSTAR MUTUALCARC 29 · TIMELY_FILING670.00
CLM00022388 Oct 2025194.00NORTHSTAR MUTUALCARC 96 · NON_COVERED194.00