ELENA NGUYEN
Dependent on policy B09M000450
Claims
1
Attributed to this person
Charged
479.00
Total submitted
Denied
479.00
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 NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000450 |
| Date of birth | 21 Oct 1996 |
| Plan | PLATINUM PPO |
| Covered from | 28 Feb 2024 |
| Covered to | 8 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001887 | 25 Mar 2024 | 479.00 | CASCADE CARE | CARC 109 · COB | 479.00 |