ELENA WILSON
Subscriber on policy B02M000077
Claims
2
Attributed to this person
Charged
728.00
Total submitted
Denied
88.00
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 WILSON |
| Role on the policy | Subscriber |
| Policy | B02M000077 |
| Date of birth | 11 Dec 1959 |
| Plan | SILVER HMO |
| Covered from | 3 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 |
|---|---|---|---|---|---|
| CLM0000358 | 18 Aug 2026 | 640.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000359 | 25 Dec 2024 | 88.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 88.00 |