GRACE CHEN
Dependent on policy B01M000749
Claims
1
Attributed to this person
Charged
321.00
Total submitted
Denied
321.00
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 | GRACE CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000749 |
| Date of birth | 23 Jun 1992 |
| Plan | PLATINUM PPO |
| Covered from | 22 Sep 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 |
|---|---|---|---|---|---|
| CLM0003336 | 13 Sep 2024 | 321.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 321.00 |