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 B04M000386›GRACE FOSTER

GRACE FOSTER

Subscriber on policy B04M000386

Claims
2
Attributed to this person
Charged
1,052.00
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
NameGRACE FOSTER
Role on the policySubscriber
PolicyB04M000386
Date of birth19 Jun 1980
PlanSILVER HMO
Covered from20 Jan 2024
Covered to25 Sep 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000165129 Jun 2024802.00MERIDIAN HEALTH PLANNot denied—
CLM000165020 Apr 2024250.00MERIDIAN HEALTH PLANNot denied—