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 B01M000125

Policy B01M000125

5 people enrolled on this policy.

People
5
On this policy
Claims attributed
10
To a named person
Policy-level
0
Not attributed to a person

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.

People on this policy

NameRoleBornClaimsDenialsDeniedPatient responsibility (835)
FIONA HUGHESSubscriber1 Jul 2003200.000.00
HENRY HUGHESDependent · 0115 Nov 2008100.000.00
MARCUS HUGHESDependent · 1912 Oct 201321296.000.00
LEILA HUGHESDependent · 1910 Dec 201621259.000.00
FIONA HUGHESDependent · 198 Sep 201731508.0060.00

Policy-level claims

Every claim on this policy is attributed to a named person.

Claims are attributed to a person from the patient loop of the 837P — name, date of birth and relationship within the policy — because the transaction carries no patient identifier. A claim that matches nobody, or more than one person, stays with the policy and is shown there rather than being assigned to a guess.