ELENA HUGHES
Dependent on policy B06M000243
Claims
3
Attributed to this person
Charged
1,123.00
Total submitted
Denied
940.00
3 denied claims
Patient responsibility
118.95
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 HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000243 |
| Date of birth | 8 Feb 1982 |
| Plan | SILVER HMO |
| Covered from | 12 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 118.95 |
| Total | 118.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001160 | 3 Apr 2026 | 216.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 216.00 |
| CLM0001159 | 14 Sep 2025 | 724.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 724.00 |
| CLM0001161 | 18 Mar 2025 | 183.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |