ELENA HUGHES
Dependent on policy B06M000314
Claims
3
Attributed to this person
Charged
1,953.00
Total submitted
Denied
822.66
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 | ELENA HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000314 |
| Date of birth | 27 Dec 1991 |
| Plan | BRONZE EPO |
| Covered from | 24 Apr 2024 |
| Covered to | 18 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001446 | 13 Nov 2024 | 664.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 244.66 |
| CLM0001447 | 20 Jul 2024 | 711.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001445 | 31 Mar 2024 | 578.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 578.00 |