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 B05M000020›AMARA QUINN

AMARA QUINN

Subscriber on policy B05M000020

Claims
1
Attributed to this person
Charged
275.00
Total submitted
Denied
84.69
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
NameAMARA QUINN
Role on the policySubscriber
PolicyB05M000020
Date of birth3 Aug 1973
PlanBRONZE EPO
Covered from29 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00000906 Aug 2025275.00NORTHSTAR MUTUALCARC 197 ยท AUTHORIZATION84.69