ELENA BAKER
Subscriber on policy B09M000640
Claims
1
Attributed to this person
Charged
108.00
Total submitted
Denied
108.00
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 BAKER |
| Role on the policy | Subscriber |
| Policy | B09M000640 |
| Date of birth | 18 Mar 1972 |
| Plan | PLATINUM PPO |
| Covered from | 30 Apr 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 |
|---|---|---|---|---|---|
| CLM0002718 | 25 Dec 2024 | 108.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 108.00 |