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.

ZARA CHEN

Dependent on policy B01M000483

Claims
1
Attributed to this person
Charged
293.00
Total submitted
Denied
293.00
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 CHEN
Role on the policyDependent · relationship 19
PolicyB01M000483
Date of birth19 Jun 2023
PlanBRONZE EPO
Covered from8 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000215116 Mar 2026293.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY293.00