ELENA ANDERSON
Dependent on policy B07M000253
Claims
3
Attributed to this person
Charged
726.00
Total submitted
Denied
495.00
2 denied claims
Patient responsibility
46.20
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 ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000253 |
| Date of birth | 10 Dec 1999 |
| Plan | BRONZE EPO |
| Covered from | 22 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 46.20 |
| Total | 46.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001078 | 26 Jul 2025 | 231.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001079 | 10 Feb 2025 | 152.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 152.00 |
| CLM0001077 | 6 Dec 2024 | 343.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 343.00 |