X12 Ingest & Denial Analytics

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.

UMA KUMAR

Subscriber on policy B06M000015

Claims
2
Attributed to this person
Charged
787.00
Total submitted
Denied
787.00
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
NameUMA KUMAR
Role on the policySubscriber
PolicyB06M000015
Date of birth17 Jun 1951
PlanSILVER HMO
Covered from17 Sep 2024
Covered to22 Dec 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000008423 Dec 2024416.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY416.00
CLM000008514 Oct 2024371.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY371.00