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 B05M000045›WENDY ANDERSON

WENDY ANDERSON

Subscriber on policy B05M000045

Claims
1
Attributed to this person
Charged
815.00
Total submitted
Denied
815.00
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 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
NameWENDY ANDERSON
Role on the policySubscriber
PolicyB05M000045
Date of birth10 Mar 1952
PlanSILVER HMO
Covered from15 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00001994 Jul 2026815.00NORTHSTAR MUTUALCARC 16 ยท BILLING_ERROR815.00