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 B06M000007

Policy B06M000007

5 people enrolled on this policy.

People
5
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)
CARLA CHENSubscriber3 Mar 198532981.720.00
BRIAN CHENDependent · 0129 Apr 197521339.000.00
ELENA CHENDependent · 193 Oct 200831750.000.00
ELENA CHENDependent · 1922 May 2009100.000.00
LEILA CHENDependent · 1922 Sep 2009331,321.000.00

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.