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.
Members›policy B06M000094›ELENA QUINN

ELENA QUINN

Subscriber on policy B06M000094

Claims
3
Attributed to this person
Charged
1,307.00
Total submitted
Denied
558.00
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
NameELENA QUINN
Role on the policySubscriber
PolicyB06M000094
Date of birth4 May 1965
PlanSILVER HMO
Covered from27 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000048629 Jul 2025749.00MERIDIAN HEALTH PLANNot denied—
CLM00004858 Jul 2025262.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING262.00
CLM000048727 Jan 2025296.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING296.00