ELENA REYES
Dependent on policy B01M000323
Claims
1
Attributed to this person
Charged
319.00
Total submitted
Denied
319.00
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 REYES |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000323 |
| Date of birth | 6 Mar 1993 |
| Plan | PLATINUM PPO |
| Covered from | 9 Aug 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 |
|---|---|---|---|---|---|
| CLM0001440 | 13 Jun 2025 | 319.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 319.00 |