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 B04M000198›OMAR ANDERSON

OMAR ANDERSON

Subscriber on policy B04M000198

Claims
1
Attributed to this person
Charged
825.00
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 ANDERSON
Role on the policySubscriber
PolicyB04M000198
Date of birth8 Sep 1979
PlanGOLD PPO
Covered from30 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00008816 Feb 2025825.00MERIDIAN HEALTH PLANNot denied—