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›GRACE BAKER

GRACE BAKER

Dependent on policy B03M000149

Claims
2
Attributed to this person
Charged
1,404.00
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
NameGRACE BAKER
Role on the policyDependent · relationship 19
PolicyB03M000149
Date of birth13 May 2016
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
CLM000061228 Aug 2025602.00MERIDIAN HEALTH PLANNot denied—
CLM00006114 Feb 2024802.00MERIDIAN HEALTH PLANNot denied—