ELENA FOSTER
Dependent on policy B07M000329
Claims
2
Attributed to this person
Charged
510.00
Total submitted
Denied
230.00
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 FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000329 |
| Date of birth | 13 Apr 2008 |
| Plan | GOLD PPO |
| Covered from | 18 Apr 2024 |
| Covered to | 4 Aug 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 |
|---|---|---|---|---|---|
| CLM0001407 | 30 May 2024 | 280.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001406 | 29 Apr 2024 | 230.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 230.00 |