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 B04M000646›BRIAN REYES

BRIAN REYES

Subscriber on policy B04M000646

Claims
3
Attributed to this person
Charged
1,999.00
Total submitted
Denied
377.00
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 REYES
Role on the policySubscriber
PolicyB04M000646
Date of birth23 May 1961
PlanSILVER HMO
Covered from4 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000281326 Apr 2025793.00CASCADE CARENot denied—
CLM000281210 Jun 2024829.00CASCADE CARENot denied—
CLM000281122 Mar 2024377.00CASCADE CARECARC 26 · ELIGIBILITY377.00