ELENA CHEN
Dependent on policy B06M000339
Claims
3
Attributed to this person
Charged
1,786.00
Total submitted
Denied
901.00
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 CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000339 |
| Date of birth | 7 Mar 2005 |
| Plan | GOLD PPO |
| Covered from | 3 Dec 2024 |
| Covered to | 1 Jul 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 |
|---|---|---|---|---|---|
| CLM0001535 | 16 Apr 2025 | 74.00 | CASCADE CARE | CARC 18 · DUPLICATE | 74.00 |
| CLM0001534 | 1 Feb 2025 | 827.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 827.00 |
| CLM0001536 | 10 Nov 2024 | 885.00 | CASCADE CARE | Not denied | — |