X12 Ingest & Denial Analytics

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 B01M000067›ZARA ANDERSON

ZARA ANDERSON

Subscriber on policy B01M000067

Claims
2
Attributed to this person
Charged
1,028.00
Total submitted
Denied
333.00
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
NameZARA ANDERSON
Role on the policySubscriber
PolicyB01M000067
Date of birth30 Aug 1964
PlanGOLD PPO
Covered from5 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000028614 Oct 2025333.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING333.00
CLM00002854 Dec 2024695.00MERIDIAN HEALTH PLANNot denied—