FIONA FOSTER
Dependent on policy B07M000174
Claims
1
Attributed to this person
Charged
274.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
41.10
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 FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000174 |
| Date of birth | 4 Aug 1995 |
| Plan | GOLD PPO |
| Covered from | 3 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 41.10 |
| Total | 41.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000702 | 23 Sep 2024 | 274.00 | MERIDIAN HEALTH PLAN | Not denied | — |