ELENA CHEN
Subscriber on policy B08M000231
Claims
1
Attributed to this person
Charged
288.00
Total submitted
Denied
288.00
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 | ELENA CHEN |
| Role on the policy | Subscriber |
| Policy | B08M000231 |
| Date of birth | 16 Jul 1952 |
| Plan | BRONZE EPO |
| Covered from | 3 Jun 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 |
|---|---|---|---|---|---|
| CLM0001043 | 23 Mar 2025 | 288.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 288.00 |