MARCUS ANDERSON
Subscriber on policy B08M000881
Claims
3
Attributed to this person
Charged
747.00
Total submitted
Denied
76.00
1 denied claims
Patient responsibility
59.40
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 | MARCUS ANDERSON |
| Role on the policy | Subscriber |
| Policy | B08M000881 |
| Date of birth | 14 Jun 1971 |
| Plan | GOLD PPO |
| Covered from | 2 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 59.40 |
| Total | 59.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003937 | 13 Nov 2024 | 396.00 | CASCADE CARE | Not denied | — |
| CLM0003939 | 14 Oct 2024 | 275.00 | CASCADE CARE | Not denied | — |
| CLM0003938 | 6 Jul 2024 | 76.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 76.00 |