X12 Ingest & Denial Analytics

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Members›policy B01M000299

Policy B01M000299

4 people enrolled on this policy.

People
4
On this policy
Claims attributed
8
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)
VICTOR USMANSubscriber24 Mar 1981200.0015.00
TOMAS USMANDependent · 015 Apr 197721575.000.00
JULIA USMANDependent · 1927 Oct 20061171.270.00
MARCUS USMANDependent · 195 Jun 2014321,153.000.00

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.