X12 Ingest & Denial Analytics

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Members›policy B02M000018›SOFIA WILSON

SOFIA WILSON

Dependent on policy B02M000018

Claims
3
Attributed to this person
Charged
2,117.00
Total submitted
Denied
496.00
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

FieldValue
NameSOFIA WILSON
Role on the policyDependent · relationship 01
PolicyB02M000018
Date of birth25 Oct 1967
PlanBRONZE EPO
Covered from19 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000010526 Aug 2026768.00MERIDIAN HEALTH PLANNot denied—
CLM000010614 Aug 2024853.00MERIDIAN HEALTH PLANNot denied—
CLM000010420 Jan 2024496.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY496.00