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 B01M000196›IVAN JOHNSON

IVAN JOHNSON

Dependent on policy B01M000196

Claims
1
Attributed to this person
Charged
859.00
Total submitted
Denied
0.00
0 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
NameIVAN JOHNSON
Role on the policyDependent · relationship 01
PolicyB01M000196
Date of birth13 Oct 1958
PlanSILVER HMO
Covered from16 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00008385 Jun 2025859.00NORTHSTAR MUTUALNot denied—