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.

OMAR CHEN

Dependent on policy B03M000462

Claims
3
Attributed to this person
Charged
1,655.00
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
NameOMAR CHEN
Role on the policyDependent · relationship 01
PolicyB03M000462
Date of birth3 Dec 1987
PlanGOLD PPO
Covered from16 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00019175 Apr 2026811.00CASCADE CARENot denied—
CLM000191620 May 2025336.00CASCADE CARENot denied—
CLM000191516 May 2025508.00CASCADE CARENot denied—