FIONA PATEL
Dependent on policy B06M000023
Claims
3
Attributed to this person
Charged
1,083.00
Total submitted
Denied
366.00
2 denied claims
Patient responsibility
268.45
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 PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000023 |
| Date of birth | 24 May 1995 |
| Plan | GOLD PPO |
| Covered from | 6 Nov 2024 |
| Covered to | 13 Feb 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 268.45 |
| Total | 268.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000145 | 11 Apr 2025 | 366.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 366.00 |
| CLM0000146 | 30 Dec 2024 | 413.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0000144 | 13 Dec 2024 | 304.00 | CASCADE CARE | Not denied | — |