ELENA QUINN
Subscriber on policy B07M000224
Claims
3
Attributed to this person
Charged
1,078.00
Total submitted
Denied
806.00
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 | ELENA QUINN |
| Role on the policy | Subscriber |
| Policy | B07M000224 |
| Date of birth | 29 Jan 1980 |
| Plan | SILVER HMO |
| Covered from | 21 Apr 2024 |
| Covered to | 12 Feb 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000939 | 6 Sep 2024 | 806.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 806.00 |
| CLM0000941 | 12 Aug 2024 | 96.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000940 | 4 May 2024 | 176.00 | NORTHSTAR MUTUAL | Not denied | — |