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 B04M000306›WENDY IQBAL

WENDY IQBAL

Subscriber on policy B04M000306

Claims
3
Attributed to this person
Charged
1,560.00
Total submitted
Denied
995.00
2 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
NameWENDY IQBAL
Role on the policySubscriber
PolicyB04M000306
Date of birth17 Dec 1970
PlanGOLD PPO
Covered from15 Apr 2024
Covered to18 Oct 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00013375 Dec 2024417.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY417.00
CLM00013361 Jun 2024578.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING578.00
CLM000133526 Apr 2024565.00MERIDIAN HEALTH PLANNot denied—