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 B02M000836›ZARA WILSON

ZARA WILSON

Dependent on policy B02M000836

Claims
2
Attributed to this person
Charged
436.00
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
NameZARA WILSON
Role on the policyDependent · relationship 19
PolicyB02M000836
Date of birth4 Oct 1981
PlanGOLD PPO
Covered from14 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00034777 Apr 2026144.00NORTHSTAR MUTUALNot denied—
CLM00034782 Jan 2026292.00NORTHSTAR MUTUALNot denied—