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 B05M000372

Policy B05M000372

5 people enrolled on this policy.

People
5
On this policy
Claims attributed
9
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)
BRIAN BAKERSubscriber9 Jan 1966200.0040.00
UMA BAKERDependent · 016 Aug 1971100.000.00
GRACE BAKERDependent · 1913 Oct 19901163.000.00
NADIA BAKERDependent · 1914 Aug 199121811.000.00
KEVIN BAKERDependent · 1916 Aug 200731465.000.00

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.