LEILA FOSTER
Dependent on policy B08M000684
Claims
1
Attributed to this person
Charged
414.00
Total submitted
Denied
414.00
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 | LEILA FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B08M000684 |
| Date of birth | 1 Jan 2020 |
| Plan | GOLD PPO |
| Covered from | 5 Mar 2024 |
| Covered to | 6 Nov 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 |
|---|---|---|---|---|---|
| CLM0003093 | 3 Mar 2024 | 414.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 414.00 |