YUSUF CHEN
Dependent on policy B07M000307
Claims
3
Attributed to this person
Charged
1,061.00
Total submitted
Denied
886.73
3 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 | YUSUF CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000307 |
| Date of birth | 24 Mar 1946 |
| Plan | SILVER HMO |
| Covered from | 4 Jan 2024 |
| Covered to | 30 Jun 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 |
|---|---|---|---|---|---|
| CLM0001319 | 28 Feb 2024 | 334.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 159.73 |
| CLM0001321 | 18 Feb 2024 | 499.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 499.00 |
| CLM0001320 | 27 Dec 2023 | 228.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 228.00 |