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 B03M000422›LEILA PATEL

LEILA PATEL

Dependent on policy B03M000422

Claims
3
Attributed to this person
Charged
501.00
Total submitted
Denied
166.00
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
NameLEILA PATEL
Role on the policyDependent · relationship 19
PolicyB03M000422
Date of birth16 Oct 2023
PlanGOLD PPO
Covered from31 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00017218 Mar 2026262.00CASCADE CARENot denied—
CLM000172017 Jan 202673.00CASCADE CARENot denied—
CLM000172219 Mar 2025166.00CASCADE CARECARC 197 · AUTHORIZATION166.00