ELENA PATEL
Dependent on policy B06M000378
Claims
3
Attributed to this person
Charged
1,298.00
Total submitted
Denied
522.00
1 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 PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000378 |
| Date of birth | 14 Jan 2007 |
| Plan | BRONZE EPO |
| Covered from | 22 Apr 2024 |
| Covered to | 14 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 |
|---|---|---|---|---|---|
| CLM0001724 | 24 Nov 2024 | 190.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001725 | 16 Aug 2024 | 522.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 522.00 |
| CLM0001726 | 11 Aug 2024 | 586.00 | NORTHSTAR MUTUAL | Not denied | — |