FIONA ANDERSON
Subscriber on policy B09M000392
Claims
3
Attributed to this person
Charged
1,612.00
Total submitted
Denied
1,230.71
3 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 | FIONA ANDERSON |
| Role on the policy | Subscriber |
| Policy | B09M000392 |
| Date of birth | 17 Aug 1960 |
| Plan | SILVER HMO |
| Covered from | 5 Jan 2025 |
| Covered to | 8 Aug 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 |
|---|---|---|---|---|---|
| CLM0001629 | 7 Aug 2025 | 391.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 9.71 |
| CLM0001628 | 29 May 2025 | 604.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 604.00 |
| CLM0001630 | 18 Mar 2025 | 617.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 617.00 |