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 B06M000125›FIONA SMITH

FIONA SMITH

Dependent on policy B06M000125

Claims
3
Attributed to this person
Charged
549.00
Total submitted
Denied
0.00
0 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
NameFIONA SMITH
Role on the policyDependent · relationship 01
PolicyB06M000125
Date of birth19 Apr 1987
PlanGOLD PPO
Covered from18 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00006173 Mar 202665.00MERIDIAN HEALTH PLANNot denied—
CLM000061919 Feb 202661.00MERIDIAN HEALTH PLANNot denied—
CLM000061810 Apr 2025423.00MERIDIAN HEALTH PLANNot denied—