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 B05M000873›PRIYA PATEL

PRIYA PATEL

Dependent on policy B05M000873

Claims
1
Attributed to this person
Charged
228.00
Total submitted
Denied
228.00
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
NamePRIYA PATEL
Role on the policyDependent · relationship 19
PolicyB05M000873
Date of birth31 May 2020
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
CLM000370624 Aug 2024228.00CASCADE CARECARC 27 · ELIGIBILITY228.00