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 B04M000329›RAVI QUINN

RAVI QUINN

Dependent on policy B04M000329

Claims
2
Attributed to this person
Charged
1,261.00
Total submitted
Denied
457.00
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
NameRAVI QUINN
Role on the policyDependent · relationship 19
PolicyB04M000329
Date of birth5 Jan 2018
PlanPLATINUM PPO
Covered from10 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00014359 Jun 2026804.00MERIDIAN HEALTH PLANNot denied—
CLM00014365 Jan 2025457.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING457.00