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 B02M000659›LEILA CHEN

LEILA CHEN

Dependent on policy B02M000659

Claims
3
Attributed to this person
Charged
1,890.00
Total submitted
Denied
682.00
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
NameLEILA CHEN
Role on the policyDependent · relationship 01
PolicyB02M000659
Date of birth20 Apr 1946
PlanPLATINUM PPO
Covered from13 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000278314 Aug 2026819.00NORTHSTAR MUTUALNot denied—
CLM000278219 Jun 2026682.00NORTHSTAR MUTUALCARC 197 · AUTHORIZATION682.00
CLM000278127 Sep 2025389.00NORTHSTAR MUTUALNot denied—