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 B04M000695›FIONA DIAZ

FIONA DIAZ

Subscriber on policy B04M000695

Claims
3
Attributed to this person
Charged
1,295.00
Total submitted
Denied
230.00
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
NameFIONA DIAZ
Role on the policySubscriber
PolicyB04M000695
Date of birth6 Jun 1966
PlanSILVER HMO
Covered from4 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00030287 Aug 2026270.00MERIDIAN HEALTH PLANNot denied—
CLM00030302 Aug 2025795.00MERIDIAN HEALTH PLANNot denied—
CLM000302920 Jun 2025230.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING230.00