ZARA CHEN
Dependent on policy B09M000067
Claims
2
Attributed to this person
Charged
706.00
Total submitted
Denied
410.00
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 | ZARA CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000067 |
| Date of birth | 24 Mar 2012 |
| Plan | BRONZE EPO |
| Covered from | 26 Nov 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 |
|---|---|---|---|---|---|
| CLM0000304 | 9 Jan 2025 | 296.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000303 | 21 Nov 2024 | 410.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 410.00 |