ELENA CHEN
Subscriber on policy B02M000222
Claims
2
Attributed to this person
Charged
1,087.00
Total submitted
Denied
809.67
2 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 | Subscriber |
| Policy | B02M000222 |
| Date of birth | 22 Apr 1969 |
| Plan | BRONZE EPO |
| Covered from | 22 Jul 2024 |
| Covered to | 4 May 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000968 | 3 Sep 2024 | 392.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 114.67 |
| CLM0000967 | 23 Jun 2024 | 695.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 695.00 |