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 B05M000427›BRIAN QUINN

BRIAN QUINN

Dependent on policy B05M000427

Claims
1
Attributed to this person
Charged
403.00
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
NameBRIAN QUINN
Role on the policyDependent · relationship 19
PolicyB05M000427
Date of birth20 Apr 2018
PlanBRONZE EPO
Covered from16 Jun 2024
Covered to4 Apr 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00018048 Dec 2024403.00MERIDIAN HEALTH PLANNot denied—