ELENA WILSON
Dependent on policy B07M000443
Claims
1
Attributed to this person
Charged
662.00
Total submitted
Denied
313.28
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 WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000443 |
| Date of birth | 24 Aug 1971 |
| Plan | SILVER HMO |
| Covered from | 16 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001872 | 5 Apr 2026 | 662.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 313.28 |