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 B08M000144

Policy B08M000144

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)
CARLA PATELSubscriber2 Jun 195921114.820.00
ELENA PATELDependent · 016 Oct 1956100.000.00
DAVID PATELDependent · 1922 Aug 198032276.800.00
KEVIN PATELDependent · 1921 May 198831791.000.00
SOFIA PATELDependent · 196 Feb 1991200.000.00

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.