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 B06M000484›YUSUF PATEL

YUSUF PATEL

Subscriber on policy B06M000484

Claims
2
Attributed to this person
Charged
901.00
Total submitted
Denied
13.13
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
NameYUSUF PATEL
Role on the policySubscriber
PolicyB06M000484
Date of birth18 Feb 1958
PlanGOLD PPO
Covered from6 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000218515 Jan 2025837.00MERIDIAN HEALTH PLANNot denied—
CLM000218619 Mar 202464.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY13.13