HENRY CHEN
Dependent on policy B10M000618
Claims
1
Attributed to this person
Charged
679.00
Total submitted
Denied
679.00
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 | HENRY CHEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000618 |
| Date of birth | 11 Mar 1994 |
| Plan | SILVER HMO |
| Covered from | 28 Mar 2024 |
| Covered to | 13 Dec 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 |
|---|---|---|---|---|---|
| CLM0002579 | 7 Nov 2024 | 679.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 679.00 |