OMAR ANDERSON
Dependent on policy B09M000070
Claims
1
Attributed to this person
Charged
158.00
Total submitted
Denied
15.55
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 | OMAR ANDERSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000070 |
| Date of birth | 2 Apr 1981 |
| Plan | SILVER HMO |
| Covered from | 20 May 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 |
|---|---|---|---|---|---|
| CLM0000318 | 20 May 2024 | 158.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 15.55 |