BRIAN ANDERSON
Subscriber on policy B09M000731
Claims
3
Attributed to this person
Charged
2,045.00
Total submitted
Denied
1,563.00
2 denied claims
Patient responsibility
20.00
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B09M000731 |
| Date of birth | 28 Mar 1951 |
| Plan | GOLD PPO |
| Covered from | 31 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003089 | 23 Nov 2024 | 894.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 894.00 |
| CLM0003090 | 22 Oct 2024 | 482.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003088 | 11 May 2024 | 669.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 669.00 |