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 B03M000843›WENDY KUMAR

WENDY KUMAR

Dependent on policy B03M000843

Claims
2
Attributed to this person
Charged
992.00
Total submitted
Denied
145.00
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
NameWENDY KUMAR
Role on the policyDependent · relationship 19
PolicyB03M000843
Date of birth15 Sep 2003
PlanBRONZE EPO
Covered from7 Mar 2024
Covered to19 Jul 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00036517 Mar 2024847.00MERIDIAN HEALTH PLANNot denied—
CLM000365025 Feb 2024145.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY145.00