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 B03M000008›UMA JOHNSON

UMA JOHNSON

Dependent on policy B03M000008

Claims
1
Attributed to this person
Charged
554.00
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
NameUMA JOHNSON
Role on the policyDependent · relationship 19
PolicyB03M000008
Date of birth25 Apr 2012
PlanPLATINUM PPO
Covered from22 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00000497 Feb 2025554.00MERIDIAN HEALTH PLANNot denied—