FIONA BAKER
Subscriber on policy B06M000678
Claims
3
Attributed to this person
Charged
1,731.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
107.70
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 BAKER |
| Role on the policy | Subscriber |
| Policy | B06M000678 |
| Date of birth | 17 Jun 1952 |
| Plan | SILVER HMO |
| Covered from | 26 Mar 2024 |
| Covered to | 13 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 107.70 |
| Total | 107.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003011 | 4 Nov 2024 | 259.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003009 | 27 Mar 2024 | 718.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003010 | 19 Mar 2024 | 754.00 | MERIDIAN HEALTH PLAN | Not denied | — |