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 B05M000299›LEILA TANAKA

LEILA TANAKA

Subscriber on policy B05M000299

Claims
3
Attributed to this person
Charged
799.00
Total submitted
Denied
279.44
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
NameLEILA TANAKA
Role on the policySubscriber
PolicyB05M000299
Date of birth14 Aug 1972
PlanSILVER HMO
Covered from7 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00012385 Jul 2026186.00CASCADE CARENot denied—
CLM00012371 Mar 202662.00CASCADE CARECARC 27 · ELIGIBILITY14.27
CLM000123922 Jan 2025551.00CASCADE CARECARC 27 · ELIGIBILITY265.17