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 B05M000640›AMARA TANAKA

AMARA TANAKA

Subscriber on policy B05M000640

Claims
3
Attributed to this person
Charged
2,222.00
Total submitted
Denied
2,222.00
3 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
NameAMARA TANAKA
Role on the policySubscriber
PolicyB05M000640
Date of birth25 Nov 1981
PlanGOLD PPO
Covered from24 Sep 2024
Covered to10 Apr 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000276531 May 2025806.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY806.00
CLM000276422 Mar 2025543.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION543.00
CLM000276314 Sep 2024873.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY873.00