ELENA PATEL
Dependent on policy B01M000203
Claims
1
Attributed to this person
Charged
408.00
Total submitted
Denied
408.00
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 PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000203 |
| Date of birth | 20 Sep 1965 |
| Plan | PLATINUM PPO |
| Covered from | 5 Feb 2024 |
| Covered to | 25 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000865 | 22 May 2024 | 408.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 408.00 |