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 B05M000819›CARLA FOSTER

CARLA FOSTER

Subscriber on policy B05M000819

Claims
2
Attributed to this person
Charged
1,159.00
Total submitted
Denied
374.00
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
NameCARLA FOSTER
Role on the policySubscriber
PolicyB05M000819
Date of birth7 Jan 1986
PlanSILVER HMO
Covered from11 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00034784 Jul 2024785.00CASCADE CARENot denied—
CLM00034779 Feb 2024374.00CASCADE CARECARC 27 · ELIGIBILITY374.00