VICTOR PATEL
Dependent on policy B09M000320
Claims
1
Attributed to this person
Charged
139.00
Total submitted
Denied
139.00
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 | VICTOR PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000320 |
| Date of birth | 27 Mar 1954 |
| Plan | SILVER HMO |
| Covered from | 6 Mar 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 |
|---|---|---|---|---|---|
| CLM0001317 | 5 Aug 2024 | 139.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 139.00 |