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 B01M000271›BRIAN VARGAS

BRIAN VARGAS

Dependent on policy B01M000271

Claims
2
Attributed to this person
Charged
725.00
Total submitted
Denied
304.00
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 — 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 VARGAS
Role on the policyDependent · relationship 01
PolicyB01M000271
Date of birth1 May 1984
PlanSILVER HMO
Covered from6 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000116416 Oct 2025421.00NORTHSTAR MUTUALNot denied—
CLM000116312 Feb 2024304.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY304.00