LEILA PATEL
Dependent on policy B08M000179
Claims
2
Attributed to this person
Charged
1,065.00
Total submitted
Denied
603.00
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 | LEILA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000179 |
| Date of birth | 26 Aug 1977 |
| Plan | BRONZE EPO |
| Covered from | 17 Aug 2024 |
| Covered to | 26 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000804 | 30 Nov 2024 | 603.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 603.00 |
| CLM0000803 | 7 Aug 2024 | 462.00 | MERIDIAN HEALTH PLAN | Not denied | — |