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 B03M000358›TOMAS KUMAR

TOMAS KUMAR

Dependent on policy B03M000358

Claims
2
Attributed to this person
Charged
857.00
Total submitted
Denied
423.00
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
NameTOMAS KUMAR
Role on the policyDependent · relationship 19
PolicyB03M000358
Date of birth2 Oct 1989
PlanPLATINUM PPO
Covered from28 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000144319 Oct 2025434.00NORTHSTAR MUTUALNot denied—
CLM00014449 Mar 2025423.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY423.00