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 B01M000096›KEVIN REYES

KEVIN REYES

Dependent on policy B01M000096

Claims
3
Attributed to this person
Charged
1,531.00
Total submitted
Denied
1,346.00
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
NameKEVIN REYES
Role on the policyDependent · relationship 19
PolicyB01M000096
Date of birth7 May 2013
PlanPLATINUM PPO
Covered from31 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000038124 Feb 2026501.00NORTHSTAR MUTUALCARC 16 · BILLING_ERROR501.00
CLM00003827 Feb 2026185.00NORTHSTAR MUTUALNot denied—
CLM000038323 Mar 2025845.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY845.00