ELENA CHEN
Dependent on policy B10M000267
Claims
2
Attributed to this person
Charged
1,268.00
Total submitted
Denied
461.00
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 | ELENA CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000267 |
| Date of birth | 19 Mar 1954 |
| Plan | GOLD PPO |
| Covered from | 14 Jan 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 |
|---|---|---|---|---|---|
| CLM0001105 | 15 Feb 2026 | 807.00 | CASCADE CARE | Not denied | — |
| CLM0001104 | 28 Jan 2026 | 461.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 461.00 |