IVAN ANDERSON
Dependent on policy B08M000877
Claims
2
Attributed to this person
Charged
1,304.00
Total submitted
Denied
1,304.00
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 | IVAN ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000877 |
| Date of birth | 5 Oct 1969 |
| Plan | GOLD PPO |
| Covered from | 3 Mar 2024 |
| Covered to | 10 Sep 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 |
|---|---|---|---|---|---|
| CLM0003921 | 16 Sep 2024 | 467.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 467.00 |
| CLM0003920 | 18 Apr 2024 | 837.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 837.00 |