DenialIntel

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B05M000410›HENRY FOSTER

HENRY FOSTER

Subscriber on policy B05M000410

Claims
1
Attributed to this person
Charged
599.00
Total submitted
Denied
599.00
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 โ€” 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
NameHENRY FOSTER
Role on the policySubscriber
PolicyB05M000410
Date of birth28 Apr 1982
PlanGOLD PPO
Covered from18 Feb 2025
Covered to27 Apr 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00017423 Jun 2025599.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY599.00