HENRY BAKER
Dependent on policy B06M000678
Claims
3
Attributed to this person
Charged
1,459.00
Total submitted
Denied
1,022.16
3 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 | HENRY BAKER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000678 |
| Date of birth | 3 Feb 1976 |
| Plan | SILVER HMO |
| Covered from | 26 Mar 2024 |
| Covered to | 13 Sep 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003015 | 28 Sep 2024 | 496.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 496.00 |
| CLM0003016 | 13 Jun 2024 | 671.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 234.16 |
| CLM0003014 | 19 Mar 2024 | 292.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 292.00 |