JULIA FOSTER
Subscriber on policy B07M000329
Claims
3
Attributed to this person
Charged
1,797.00
Total submitted
Denied
708.00
1 denied claims
Patient responsibility
60.75
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 | JULIA FOSTER |
| Role on the policy | Subscriber |
| Policy | B07M000329 |
| Date of birth | 17 Jul 2000 |
| Plan | GOLD PPO |
| Covered from | 18 Apr 2024 |
| Covered to | 4 Aug 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 60.75 |
| Total | 60.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001405 | 25 Sep 2024 | 405.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001403 | 3 Jun 2024 | 684.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001404 | 26 May 2024 | 708.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 708.00 |