FIONA ANDERSON
Dependent on policy B10M000654
Claims
3
Attributed to this person
Charged
1,335.00
Total submitted
Denied
433.00
2 denied claims
Patient responsibility
234.00
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 | FIONA ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000654 |
| Date of birth | 14 Jul 1944 |
| Plan | BRONZE EPO |
| Covered from | 13 Apr 2025 |
| Covered to | 18 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 234.00 |
| Total | 234.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002709 | 25 Sep 2025 | 433.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 433.00 |
| CLM0002707 | 10 Sep 2025 | 542.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002708 | 9 Jul 2025 | 360.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |