VICTOR GARCIA
Dependent on policy B07M000883
Claims
2
Attributed to this person
Charged
821.00
Total submitted
Denied
567.00
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 | VICTOR GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000883 |
| Date of birth | 10 Apr 1955 |
| Plan | PLATINUM PPO |
| Covered from | 12 Jan 2024 |
| Covered to | 14 Jul 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 |
|---|---|---|---|---|---|
| CLM0003665 | 20 Apr 2024 | 567.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 567.00 |
| CLM0003664 | 3 Feb 2024 | 254.00 | MERIDIAN HEALTH PLAN | Not denied | — |