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 B04M000159›JULIA QUINN

JULIA QUINN

Dependent on policy B04M000159

Claims
2
Attributed to this person
Charged
1,200.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
72.90
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
NameJULIA QUINN
Role on the policyDependent · relationship 19
PolicyB04M000159
Date of birth28 Feb 2010
PlanGOLD PPO
Covered from21 Nov 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 1 · Deductible172.90
Total72.90

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000072610 Aug 2026486.00MERIDIAN HEALTH PLANNot denied—
CLM000072727 May 2026714.00MERIDIAN HEALTH PLANNot denied—