AMARA SMITH
Subscriber on policy B02M000467
Claims
1
Attributed to this person
Charged
230.00
Total submitted
Denied
230.00
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 | AMARA SMITH |
| Role on the policy | Subscriber |
| Policy | B02M000467 |
| Date of birth | 14 Nov 1982 |
| Plan | SILVER HMO |
| Covered from | 11 Oct 2024 |
| Covered to | 8 Jan 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001995 | 18 Feb 2025 | 230.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 230.00 |