FIONA PATEL
Dependent on policy B02M000424
Claims
3
Attributed to this person
Charged
1,992.00
Total submitted
Denied
654.00
1 denied claims
Patient responsibility
106.35
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 | FIONA PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000424 |
| Date of birth | 12 Dec 1961 |
| Plan | GOLD PPO |
| Covered from | 23 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 106.35 |
| Total | 106.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001809 | 26 Jul 2025 | 629.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001808 | 4 Jun 2025 | 709.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001807 | 6 May 2025 | 654.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 654.00 |