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 B04M000397›BRIAN TANAKA

BRIAN TANAKA

Subscriber on policy B04M000397

Claims
2
Attributed to this person
Charged
1,026.00
Total submitted
Denied
229.00
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
NameBRIAN TANAKA
Role on the policySubscriber
PolicyB04M000397
Date of birth6 May 1992
PlanBRONZE EPO
Covered from8 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000170630 Jul 2024797.00CASCADE CARENot denied—
CLM000170730 Mar 2024229.00CASCADE CARECARC 197 · AUTHORIZATION229.00