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.

IVAN CHEN

Subscriber on policy B03M000413

Claims
1
Attributed to this person
Charged
585.00
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
NameIVAN CHEN
Role on the policySubscriber
PolicyB03M000413
Date of birth2 Jun 1954
PlanSILVER HMO
Covered from18 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000167530 Dec 2024585.00NORTHSTAR MUTUALNot denied—