KEVIN HUGHES
Dependent on policy B07M000797
Claims
3
Attributed to this person
Charged
1,336.00
Total submitted
Denied
462.00
1 denied claims
Patient responsibility
109.80
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 | KEVIN HUGHES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000797 |
| Date of birth | 29 Jun 1996 |
| Plan | PLATINUM PPO |
| Covered from | 17 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 109.80 |
| Total | 109.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003293 | 29 Mar 2025 | 462.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 462.00 |
| CLM0003295 | 24 Jul 2024 | 325.00 | CASCADE CARE | Not denied | — |
| CLM0003294 | 10 May 2024 | 549.00 | CASCADE CARE | Not denied | — |