WENDY QUINN
Subscriber on policy B07M000337
Claims
3
Attributed to this person
Charged
1,183.00
Total submitted
Denied
74.00
1 denied claims
Patient responsibility
112.60
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 | WENDY QUINN |
| Role on the policy | Subscriber |
| Policy | B07M000337 |
| Date of birth | 15 Apr 1969 |
| Plan | GOLD PPO |
| Covered from | 30 May 2024 |
| Covered to | 13 Dec 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 112.60 |
| Total | 112.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001440 | 28 Nov 2024 | 563.00 | CASCADE CARE | Not denied | — |
| CLM0001439 | 7 Nov 2024 | 546.00 | CASCADE CARE | Not denied | — |
| CLM0001438 | 12 Aug 2024 | 74.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 74.00 |