IVAN CHEN
Subscriber on policy B02M000573
Claims
1
Attributed to this person
Charged
688.00
Total submitted
Denied
688.00
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 | IVAN CHEN |
| Role on the policy | Subscriber |
| Policy | B02M000573 |
| Date of birth | 23 Jul 1989 |
| Plan | PLATINUM PPO |
| Covered from | 4 Apr 2024 |
| Covered to | 26 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002404 | 13 Mar 2024 | 688.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 688.00 |