DenialIntel

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Members›policy B03M000003

Policy B03M000003

3 people enrolled on this policy.

People
3
On this policy
Claims attributed
4
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)
MARCUS SMITHSubscriber8 Apr 19522135.160.00
VICTOR SMITHDependent · 0120 Apr 195211768.000.00
SOFIA SMITHDependent · 1910 Dec 197811716.000.00

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.