ELENA DIAZ
Dependent on policy B09M000823
Claims
2
Attributed to this person
Charged
627.00
Total submitted
Denied
257.00
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 DIAZ |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000823 |
| Date of birth | 9 Oct 1979 |
| Plan | PLATINUM PPO |
| Covered from | 7 Jan 2025 |
| Covered to | 27 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003502 | 16 May 2025 | 257.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 257.00 |
| CLM0003501 | 25 Mar 2025 | 370.00 | MERIDIAN HEALTH PLAN | Not denied | — |