VICTOR QUINN
Dependent on policy B10M000277
Claims
3
Attributed to this person
Charged
1,081.00
Total submitted
Denied
483.00
1 denied claims
Patient responsibility
101.60
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 | VICTOR QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000277 |
| Date of birth | 15 Dec 1990 |
| Plan | PLATINUM PPO |
| Covered from | 24 Mar 2024 |
| Covered to | 24 Dec 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 101.60 |
| Total | 101.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001171 | 27 Nov 2024 | 483.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 483.00 |
| CLM0001169 | 20 Jul 2024 | 508.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001170 | 20 Jun 2024 | 90.00 | MERIDIAN HEALTH PLAN | Not denied | — |