ELENA EVANS
Subscriber on policy B06M000353
Claims
2
Attributed to this person
Charged
1,162.00
Total submitted
Denied
610.00
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 EVANS |
| Role on the policy | Subscriber |
| Policy | B06M000353 |
| Date of birth | 9 Aug 2000 |
| Plan | SILVER HMO |
| Covered from | 30 Aug 2024 |
| Covered to | 6 Apr 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 |
|---|---|---|---|---|---|
| CLM0001605 | 31 Jan 2025 | 552.00 | CASCADE CARE | Not denied | — |
| CLM0001604 | 24 Aug 2024 | 610.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 610.00 |