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 B01M000501›HENRY JOHNSON

HENRY JOHNSON

Subscriber on policy B01M000501

Claims
2
Attributed to this person
Charged
808.00
Total submitted
Denied
468.00
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
NameHENRY JOHNSON
Role on the policySubscriber
PolicyB01M000501
Date of birth27 Jul 1959
PlanGOLD PPO
Covered from6 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000224628 Sep 2025468.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING468.00
CLM000224515 Sep 2025340.00MERIDIAN HEALTH PLANNot denied—