JULIA SMITH
Subscriber on policy B01M000486
Claims
3
Attributed to this person
Charged
425.00
Total submitted
Denied
150.00
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 | JULIA SMITH |
| Role on the policy | Subscriber |
| Policy | B01M000486 |
| Date of birth | 11 Aug 1963 |
| Plan | SILVER HMO |
| Covered from | 25 Mar 2024 |
| Covered to | 5 Jan 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 |
|---|---|---|---|---|---|
| CLM0002169 | 13 Jan 2025 | 150.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 150.00 |
| CLM0002171 | 23 Jul 2024 | 113.00 | CASCADE CARE | Not denied | — |
| CLM0002170 | 28 May 2024 | 162.00 | CASCADE CARE | Not denied | — |