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 B01M000517›RAVI REYES

RAVI REYES

Dependent on policy B01M000517

Claims
3
Attributed to this person
Charged
1,830.00
Total submitted
Denied
610.00
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
NameRAVI REYES
Role on the policyDependent · relationship 19
PolicyB01M000517
Date of birth24 Oct 2008
PlanBRONZE EPO
Covered from5 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000233424 Dec 2025447.00MERIDIAN HEALTH PLANNot denied—
CLM000233515 Jul 2025773.00MERIDIAN HEALTH PLANNot denied—
CLM00023337 Jun 2025610.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR610.00