WENDY FOSTER
Subscriber on policy B07M000822
Claims
2
Attributed to this person
Charged
669.00
Total submitted
Denied
200.93
1 denied claims
Patient responsibility
36.45
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 FOSTER |
| Role on the policy | Subscriber |
| Policy | B07M000822 |
| Date of birth | 30 Jun 1951 |
| Plan | PLATINUM PPO |
| Covered from | 5 Jun 2024 |
| Covered to | 13 Feb 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 36.45 |
| Total | 36.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003368 | 26 Mar 2025 | 243.00 | CASCADE CARE | Not denied | — |
| CLM0003367 | 3 Nov 2024 | 426.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 200.93 |