GRACE FOSTER
Dependent on policy B07M000259
Claims
3
Attributed to this person
Charged
1,402.00
Total submitted
Denied
773.04
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 | GRACE FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000259 |
| Date of birth | 26 Sep 2007 |
| Plan | BRONZE EPO |
| Covered from | 1 Jun 2024 |
| Covered to | 1 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001113 | 10 Aug 2024 | 356.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 356.00 |
| CLM0001111 | 21 Jul 2024 | 197.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001112 | 10 Jun 2024 | 849.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 417.04 |