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Patient Billing

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Patient Information

Ah
Ahmed Mohammed Al-Ali

National ID: 1234567890

Insurance Number: INS-2024-001234
Insurance Provider: Cooperative Insurance Company
Policy Number: POL-2024-001234
Coverage Percentage: 80%
Deductible: $500

Eligibility Status

Status: Eligible
Verification Date: 2024-01-15 09:15:00
Expiry Date: 2024-12-31
Coverage Type: comprehensive
Covered Services:
  • inpatient
  • outpatient
  • pharmacy
  • laboratory
  • radiology
Approved
Ah
CLM-2024-001234
2024-01-15
Amount

$1,500

Payment

$1,200

2024-01-20

View Details Print Receipt
Approved
Ah
CLM-2024-001200
2024-01-10
Amount

$800

Payment

$640

2024-01-15

View Details Print Receipt
PAY-2024-001234
Ah
$1,200
2024-01-20
Method

Bank Transfer

Status

Completed

View Details Print Receipt
PAY-2024-001200
Ah
$640
2024-01-15
Method

Bank Transfer

Status

Completed

View Details Print Receipt
Submitted
Ah
CLM-2024-001235
2024-01-16
Amount

$2,200

Submission

2024-01-16 10:00:00

View Details Edit

NPHIES Verification

Last Verification: 2024-01-15 09:15:00
Verification Status: Success
NPHIES Reference: NPH-2024-001234
Response Time: 1.2s
Coverage Details:
  • Policy Status Active
  • Coverage Percentage 80%
  • Remaining Deductible $200
  • Remaining Annual Limit $45,000

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