X12 Ingest & Denial Analytics

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 B05M000260›VICTOR HUGHES

VICTOR HUGHES

Dependent on policy B05M000260

Claims
3
Attributed to this person
Charged
1,884.00
Total submitted
Denied
1,176.00
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
NameVICTOR HUGHES
Role on the policyDependent · relationship 01
PolicyB05M000260
Date of birth2 Jul 1959
PlanPLATINUM PPO
Covered from18 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00010797 Nov 2025580.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY580.00
CLM00010813 May 2025596.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY596.00
CLM000108024 Apr 2025708.00MERIDIAN HEALTH PLANNot denied—