GRACE HUGHES
Dependent on policy B07M000817
Claims
2
Attributed to this person
Charged
497.00
Total submitted
Denied
191.00
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 | GRACE HUGHES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000817 |
| Date of birth | 25 Aug 1975 |
| Plan | SILVER HMO |
| Covered from | 25 Apr 2024 |
| Covered to | 14 Feb 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 |
|---|---|---|---|---|---|
| CLM0003351 | 15 Oct 2024 | 306.00 | CASCADE CARE | Not denied | — |
| CLM0003350 | 10 Apr 2024 | 191.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 191.00 |