SOFIA ANDERSON
Dependent on policy B08M000413
Claims
3
Attributed to this person
Charged
922.00
Total submitted
Denied
713.00
2 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 | SOFIA ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000413 |
| Date of birth | 3 Jun 1967 |
| Plan | PLATINUM PPO |
| Covered from | 2 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001901 | 9 Nov 2024 | 583.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 583.00 |
| CLM0001903 | 15 Sep 2024 | 209.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001902 | 16 Apr 2024 | 130.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 130.00 |