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 B05M000206›HENRY NGUYEN

HENRY NGUYEN

Subscriber on policy B05M000206

Claims
3
Attributed to this person
Charged
1,408.00
Total submitted
Denied
447.20
2 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
NameHENRY NGUYEN
Role on the policySubscriber
PolicyB05M000206
Date of birth24 Oct 1957
PlanPLATINUM PPO
Covered from13 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00008646 Aug 2025425.00NORTHSTAR MUTUALNot denied—
CLM000086231 Jan 2025773.00NORTHSTAR MUTUALCARC 29 · TIMELY_FILING237.20
CLM000086318 Jan 2025210.00NORTHSTAR MUTUALCARC 197 · AUTHORIZATION210.00