FIONA FOSTER
Dependent on policy B09M000740
Claims
3
Attributed to this person
Charged
1,580.00
Total submitted
Denied
1,359.00
3 denied claims
Patient responsibility
143.65
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 | FIONA FOSTER |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000740 |
| Date of birth | 3 Oct 1982 |
| Plan | SILVER HMO |
| Covered from | 23 Aug 2024 |
| Covered to | 31 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 143.65 |
| Total | 143.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003134 | 18 Jul 2025 | 221.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0003132 | 14 Sep 2024 | 601.00 | CASCADE CARE | CARC 29 · TIMELY_FILING | 601.00 |
| CLM0003133 | 11 Aug 2024 | 758.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 758.00 |