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 B09M000403

Policy B09M000403

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)
OMAR HUGHESSubscriber11 Aug 1988100.000.00
ZARA HUGHESDependent · 0126 Jun 1990300.000.00
UMA HUGHESDependent · 196 Jun 202033524.000.00
OMAR HUGHESDependent · 1925 Aug 202031155.820.00
HENRY HUGHESDependent · 1927 Mar 2022100.000.00

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.