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 B04M000010›IVAN HUGHES

IVAN HUGHES

Dependent on policy B04M000010

Claims
1
Attributed to this person
Charged
601.00
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 HUGHES
Role on the policyDependent · relationship 01
PolicyB04M000010
Date of birth20 Aug 1996
PlanBRONZE EPO
Covered from20 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000005327 Mar 2025601.00MERIDIAN HEALTH PLANNot denied—