RAVI WILSON
Subscriber on policy B09M000255
Claims
1
Attributed to this person
Charged
315.00
Total submitted
Denied
315.00
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 | RAVI WILSON |
| Role on the policy | Subscriber |
| Policy | B09M000255 |
| Date of birth | 27 Dec 1998 |
| Plan | PLATINUM PPO |
| Covered from | 27 Oct 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 |
|---|---|---|---|---|---|
| CLM0001030 | 9 Jan 2025 | 315.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 315.00 |