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 B04M000882›MARCUS FOSTER

MARCUS FOSTER

Subscriber on policy B04M000882

Claims
3
Attributed to this person
Charged
2,038.00
Total submitted
Denied
899.00
1 denied claims
Patient responsibility
123.40
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
NameMARCUS FOSTER
Role on the policySubscriber
PolicyB04M000882
Date of birth22 Oct 1990
PlanPLATINUM PPO
Covered from12 Sep 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 2 · Coinsurance1123.40
Total123.40

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00038167 Jun 2026899.00CASCADE CARECARC 27 · ELIGIBILITY899.00
CLM000381725 Dec 2025522.00CASCADE CARENot denied—
CLM000381518 Feb 2025617.00CASCADE CARENot denied—