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 B05M000145›MARCUS DIAZ

MARCUS DIAZ

Subscriber on policy B05M000145

Claims
2
Attributed to this person
Charged
1,090.00
Total submitted
Denied
759.00
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 — 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
NameMARCUS DIAZ
Role on the policySubscriber
PolicyB05M000145
Date of birth31 Jan 1968
PlanSILVER HMO
Covered from24 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000060011 May 2026331.00CASCADE CARENot denied—
CLM000059912 Sep 2024759.00CASCADE CARECARC 27 · ELIGIBILITY759.00