VICTOR PATEL
Dependent on policy B08M000179
Claims
1
Attributed to this person
Charged
291.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
43.65
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 | VICTOR PATEL |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000179 |
| Date of birth | 12 Jan 1988 |
| Plan | BRONZE EPO |
| Covered from | 17 Aug 2024 |
| Covered to | 26 Oct 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 43.65 |
| Total | 43.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000807 | 30 Oct 2024 | 291.00 | MERIDIAN HEALTH PLAN | Not denied | — |