X12 Ingest & Denial Analytics

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Members›policy B02M000056›ELENA REYES

ELENA REYES

Dependent on policy B02M000056

Claims
3
Attributed to this person
Charged
2,291.00
Total submitted
Denied
790.00
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
NameELENA REYES
Role on the policyDependent · relationship 19
PolicyB02M000056
Date of birth24 Sep 1996
PlanSILVER HMO
Covered from4 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000026623 May 2026682.00MERIDIAN HEALTH PLANNot denied—
CLM00002652 Oct 2025819.00MERIDIAN HEALTH PLANNot denied—
CLM000026728 Apr 2024790.00MERIDIAN HEALTH PLANCARC 96 · NON_COVERED790.00