ELENA FOSTER
Subscriber on policy B01M000539
Claims
3
Attributed to this person
Charged
1,649.00
Total submitted
Denied
390.00
1 denied claims
Patient responsibility
98.00
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 FOSTER |
| Role on the policy | Subscriber |
| Policy | B01M000539 |
| Date of birth | 13 Sep 1953 |
| Plan | GOLD PPO |
| Covered from | 9 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 98.00 |
| Total | 98.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002426 | 10 Oct 2025 | 390.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 390.00 |
| CLM0002425 | 17 Jul 2025 | 769.00 | CASCADE CARE | Not denied | — |
| CLM0002427 | 13 Jul 2025 | 490.00 | CASCADE CARE | Not denied | — |