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 B01M000390›OMAR QUINN

OMAR QUINN

Dependent on policy B01M000390

Claims
2
Attributed to this person
Charged
1,098.00
Total submitted
Denied
0.00
0 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
NameOMAR QUINN
Role on the policyDependent · relationship 01
PolicyB01M000390
Date of birth5 Dec 1953
PlanGOLD PPO
Covered from5 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000173522 Apr 2026648.00NORTHSTAR MUTUALNot denied—
CLM00017342 Apr 2025450.00NORTHSTAR MUTUALNot denied—