DenialIntel

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ZARA CHEN

Dependent on policy B09M000390

Claims
2
Attributed to this person
Charged
606.00
Total submitted
Denied
523.00
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

FieldValue
NameZARA CHEN
Role on the policyDependent · relationship 01
PolicyB09M000390
Date of birth29 Mar 1981
PlanBRONZE EPO
Covered from26 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000161823 Sep 202583.00NORTHSTAR MUTUALNot denied—
CLM00016195 May 2024523.00NORTHSTAR MUTUALCARC 26 · ELIGIBILITY523.00