X12 Ingest & Denial Analytics

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 B03M000006›OMAR USMAN

OMAR USMAN

Dependent on policy B03M000006

Claims
3
Attributed to this person
Charged
833.00
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
NameOMAR USMAN
Role on the policyDependent · relationship 19
PolicyB03M000006
Date of birth26 Sep 2013
PlanSILVER HMO
Covered from19 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000003215 Jul 202674.00MERIDIAN HEALTH PLANNot denied—
CLM000003118 May 202590.00MERIDIAN HEALTH PLANNot denied—
CLM000003321 Aug 2024669.00MERIDIAN HEALTH PLANNot denied—