BRIAN PATEL
Dependent on policy B08M000431
Claims
1
Attributed to this person
Charged
612.00
Total submitted
Denied
612.00
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 | BRIAN PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000431 |
| Date of birth | 27 Aug 1967 |
| Plan | PLATINUM PPO |
| Covered from | 24 Jul 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 |
|---|---|---|---|---|---|
| CLM0001980 | 26 Jul 2024 | 612.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 612.00 |