FIONA EVANS
Subscriber on policy B06M000623
Claims
2
Attributed to this person
Charged
653.00
Total submitted
Denied
432.60
2 denied claims
Patient responsibility
0.00
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 | FIONA EVANS |
| Role on the policy | Subscriber |
| Policy | B06M000623 |
| Date of birth | 3 Oct 1989 |
| Plan | BRONZE EPO |
| Covered from | 12 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002780 | 2 Apr 2025 | 332.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 111.60 |
| CLM0002779 | 21 Aug 2024 | 321.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 321.00 |