GRACE CHEN
Dependent on policy B01M000379
Claims
3
Attributed to this person
Charged
1,104.00
Total submitted
Denied
1,104.00
3 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 | GRACE CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000379 |
| Date of birth | 2 Nov 1981 |
| Plan | GOLD PPO |
| Covered from | 18 Oct 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 |
|---|---|---|---|---|---|
| CLM0001685 | 5 May 2025 | 501.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 501.00 |
| CLM0001684 | 6 Dec 2024 | 482.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 482.00 |
| CLM0001683 | 4 Nov 2024 | 121.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 121.00 |