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 B03M000149›CARLA BAKER

CARLA BAKER

Dependent on policy B03M000149

Claims
2
Attributed to this person
Charged
957.00
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
NameCARLA BAKER
Role on the policyDependent · relationship 01
PolicyB03M000149
Date of birth2 Nov 1986
PlanBRONZE EPO
Covered from15 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00006094 May 2026551.00MERIDIAN HEALTH PLANNot denied—
CLM000061011 Aug 2024406.00MERIDIAN HEALTH PLANNot denied—