ELENA HUGHES
Dependent on policy B08M000352
Claims
2
Attributed to this person
Charged
229.00
Total submitted
Denied
99.00
1 denied claims
Patient responsibility
50.00
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 | ELENA HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000352 |
| Date of birth | 23 Apr 2008 |
| Plan | PLATINUM PPO |
| Covered from | 1 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001615 | 2 Oct 2025 | 99.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 99.00 |
| CLM0001616 | 13 Aug 2025 | 130.00 | MERIDIAN HEALTH PLAN | Not denied | — |