ELENA PATEL
Dependent on policy B07M000183
Claims
1
Attributed to this person
Charged
69.00
Total submitted
Denied
69.00
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 PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000183 |
| Date of birth | 29 Jul 2007 |
| Plan | BRONZE EPO |
| Covered from | 10 Apr 2025 |
| Covered to | 13 Oct 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 |
|---|---|---|---|---|---|
| CLM0000757 | 16 May 2025 | 69.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 69.00 |