X12 Ingest & Denial Analytics

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Members›policy B05M000543›BRIAN WILSON

BRIAN WILSON

Dependent on policy B05M000543

Claims
3
Attributed to this person
Charged
1,788.00
Total submitted
Denied
114.45
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
NameBRIAN WILSON
Role on the policyDependent · relationship 01
PolicyB05M000543
Date of birth24 Apr 1949
PlanGOLD 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
CLM000232228 Jun 2026677.00CASCADE CARENot denied—
CLM000232325 Mar 2026312.00CASCADE CARECARC 27 · ELIGIBILITY114.45
CLM000232422 Nov 2025799.00CASCADE CARENot denied—