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 B01M000105›ZARA PATEL

ZARA PATEL

Subscriber on policy B01M000105

Claims
3
Attributed to this person
Charged
2,158.00
Total submitted
Denied
565.00
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
NameZARA PATEL
Role on the policySubscriber
PolicyB01M000105
Date of birth18 Jan 1950
PlanBRONZE EPO
Covered from28 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004229 Jul 2026889.00NORTHSTAR MUTUALNot denied—
CLM000042329 Apr 2026704.00NORTHSTAR MUTUALNot denied—
CLM000042124 Jul 2024565.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY565.00