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 B05M000598›OMAR PATEL

OMAR PATEL

Subscriber on policy B05M000598

Claims
3
Attributed to this person
Charged
1,686.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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
NameOMAR PATEL
Role on the policySubscriber
PolicyB05M000598
Date of birth16 May 1971
PlanPLATINUM PPO
Covered from17 Apr 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 3 · Copay140.00
Total40.00

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000256418 Jan 2026305.00MERIDIAN HEALTH PLANNot denied—
CLM000256328 Nov 2025790.00MERIDIAN HEALTH PLANNot denied—
CLM000256526 Jun 2025591.00MERIDIAN HEALTH PLANNot denied—