FIONA EVANS
Subscriber on policy B10M000859
Claims
1
Attributed to this person
Charged
240.00
Total submitted
Denied
95.51
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 | FIONA EVANS |
| Role on the policy | Subscriber |
| Policy | B10M000859 |
| Date of birth | 15 May 1975 |
| Plan | BRONZE EPO |
| Covered from | 1 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003637 | 4 Oct 2024 | 240.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 95.51 |