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 B04M000243›OMAR PATEL

OMAR PATEL

Dependent on policy B04M000243

Claims
3
Attributed to this person
Charged
1,418.00
Total submitted
Denied
1,053.22
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
NameOMAR PATEL
Role on the policyDependent · relationship 19
PolicyB04M000243
Date of birth23 Oct 2014
PlanGOLD PPO
Covered from21 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00010592 Mar 2026156.00CASCADE CARENot denied—
CLM000105816 Feb 2025374.00CASCADE CARECARC 16 · BILLING_ERROR165.22
CLM00010608 Feb 2025888.00CASCADE CARECARC 27 · ELIGIBILITY888.00