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 B01M000082›OMAR WILSON

OMAR WILSON

Subscriber on policy B01M000082

Claims
3
Attributed to this person
Charged
2,274.00
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 WILSON
Role on the policySubscriber
PolicyB01M000082
Date of birth29 Aug 1978
PlanGOLD PPO
Covered from12 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000033320 Jul 2026748.00NORTHSTAR MUTUALNot denied—
CLM000033129 Mar 2026632.00NORTHSTAR MUTUALNot denied—
CLM000033220 Oct 2025894.00NORTHSTAR MUTUALNot denied—