UMA QUINN
Dependent on policy B02M000596
Claims
2
Attributed to this person
Charged
392.00
Total submitted
Denied
182.00
1 denied claims
Patient responsibility
31.50
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 | UMA QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000596 |
| Date of birth | 25 Jun 1948 |
| Plan | GOLD PPO |
| Covered from | 7 Aug 2024 |
| Covered to | 23 Dec 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 31.50 |
| Total | 31.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002498 | 23 Sep 2024 | 182.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 182.00 |
| CLM0002499 | 20 Jul 2024 | 210.00 | CASCADE CARE | Not denied | — |