SOFIA GARCIA
Dependent on policy B07M000883
Claims
3
Attributed to this person
Charged
1,066.00
Total submitted
Denied
728.00
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 | SOFIA GARCIA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000883 |
| Date of birth | 17 Jul 1991 |
| 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 |
|---|---|---|---|---|---|
| CLM0003668 | 23 Jul 2024 | 639.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 639.00 |
| CLM0003666 | 27 Jun 2024 | 338.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003667 | 14 Apr 2024 | 89.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 89.00 |