ELENA PATEL
Dependent on policy B06M000557
Claims
2
Attributed to this person
Charged
839.00
Total submitted
Denied
133.00
1 denied claims
Patient responsibility
141.20
Reported on the 835
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.
Who this is
| Field | Value |
|---|---|
| Name | ELENA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000557 |
| Date of birth | 3 Apr 1997 |
| Plan | PLATINUM PPO |
| Covered from | 13 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 141.20 |
| Total | 141.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002487 | 18 Aug 2025 | 133.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 133.00 |
| CLM0002486 | 16 Dec 2024 | 706.00 | MERIDIAN HEALTH PLAN | Not denied | — |