ELENA QUINN
Subscriber on policy B10M000869
Claims
3
Attributed to this person
Charged
1,777.00
Total submitted
Denied
1,370.00
2 denied claims
Patient responsibility
61.05
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 | ELENA QUINN |
| Role on the policy | Subscriber |
| Policy | B10M000869 |
| Date of birth | 18 Apr 1970 |
| Plan | SILVER HMO |
| Covered from | 9 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 61.05 |
| Total | 61.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003687 | 12 Jun 2026 | 519.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 519.00 |
| CLM0003689 | 20 Dec 2025 | 407.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003688 | 10 Aug 2025 | 851.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 851.00 |