ELENA QUINN
Dependent on policy B08M000762
Claims
1
Attributed to this person
Charged
376.00
Total submitted
Denied
376.00
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 QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000762 |
| Date of birth | 28 Jun 1984 |
| Plan | PLATINUM PPO |
| Covered from | 27 Apr 2025 |
| Covered to | 7 Jan 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003403 | 28 Apr 2025 | 376.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 376.00 |