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 B06M000290›GRACE FOSTER

GRACE FOSTER

Dependent on policy B06M000290

Claims
1
Attributed to this person
Charged
796.00
Total submitted
Denied
796.00
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
NameGRACE FOSTER
Role on the policyDependent · relationship 19
PolicyB06M000290
Date of birth29 Jun 2008
PlanSILVER HMO
Covered from24 Sep 2024
Covered to7 Apr 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000135124 Feb 2025796.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY796.00