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 B09M000423

Policy B09M000423

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)
JULIA CHENSubscriber22 Sep 1980110.00367.90
OMAR CHENDependent · 0120 Apr 1984100.000.00
PRIYA CHENDependent · 1921 Apr 2003200.00149.00
ZARA CHENDependent · 1918 Oct 201331822.000.00
KEVIN CHENDependent · 1920 Jun 202221216.000.00

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.