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 B03M000362›WENDY WILSON

WENDY WILSON

Subscriber on policy B03M000362

Claims
2
Attributed to this person
Charged
755.00
Total submitted
Denied
755.00
2 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 WILSON
Role on the policySubscriber
PolicyB03M000362
Date of birth12 Jul 1971
PlanGOLD PPO
Covered from24 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000146320 Mar 2026392.00NORTHSTAR MUTUALCARC 96 · NON_COVERED392.00
CLM00014641 Mar 2025363.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY363.00