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 B03M000364›IVAN ANDERSON

IVAN ANDERSON

Dependent on policy B03M000364

Claims
3
Attributed to this person
Charged
1,264.00
Total submitted
Denied
622.00
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
NameIVAN ANDERSON
Role on the policyDependent · relationship 01
PolicyB03M000364
Date of birth29 Jul 1957
PlanPLATINUM PPO
Covered from14 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000147916 Aug 2026279.00MERIDIAN HEALTH PLANNot denied—
CLM000147812 Jan 2026363.00MERIDIAN HEALTH PLANNot denied—
CLM000148024 May 2025622.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY622.00