X12 Ingest & Denial Analytics

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Members›policy B05M000873›ZARA PATEL

ZARA PATEL

Dependent on policy B05M000873

Claims
2
Attributed to this person
Charged
755.00
Total submitted
Denied
658.00
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
NameZARA PATEL
Role on the policyDependent · relationship 01
PolicyB05M000873
Date of birth5 Sep 2001
PlanGOLD PPO
Covered from27 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000370421 Jul 202697.00CASCADE CARENot denied—
CLM00037052 May 2026658.00CASCADE CARECARC 50 · MEDICAL_NECESSITY658.00