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 B08M000116

Policy B08M000116

5 people enrolled on this policy.

People
5
On this policy
Claims attributed
11
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 YAMADASubscriber22 Dec 1982200.000.00
PRIYA YAMADADependent · 012 Jan 1984321,116.000.00
WENDY YAMADADependent · 1919 Nov 2010200.00155.00
AMARA YAMADADependent · 1922 May 202231839.0050.00
HENRY YAMADADependent · 1925 Jun 2023100.000.00

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.