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 B01M000398

Policy B01M000398

4 people enrolled on this policy.

People
4
On this policy
Claims attributed
12
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)
HENRY JOHNSONSubscriber30 Jan 1983320.00644.15
HENRY JOHNSONDependent · 0112 Oct 198132700.000.00
JULIA JOHNSONDependent · 1924 May 200431383.000.00
BRIAN JOHNSONDependent · 1929 Aug 200831127.000.00

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.