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 B04M000857›RAVI IQBAL

RAVI IQBAL

Dependent on policy B04M000857

Claims
2
Attributed to this person
Charged
1,422.00
Total submitted
Denied
1,422.00
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
NameRAVI IQBAL
Role on the policyDependent · relationship 19
PolicyB04M000857
Date of birth23 Mar 2012
PlanGOLD PPO
Covered from20 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00037084 Mar 2026662.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY662.00
CLM000370914 Sep 2025760.00NORTHSTAR MUTUALCARC 29 · TIMELY_FILING760.00