FIONA ANDERSON
Subscriber on policy B02M000862
Claims
3
Attributed to this person
Charged
1,082.00
Total submitted
Denied
87.00
2 denied claims
Patient responsibility
449.20
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 ANDERSON |
| Role on the policy | Subscriber |
| Policy | B02M000862 |
| Date of birth | 1 Aug 1970 |
| Plan | GOLD PPO |
| Covered from | 15 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 361.40 |
| CARC 2 · Coinsurance | 1 | 87.80 |
| Total | 449.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003594 | 1 Jul 2025 | 439.00 | CASCADE CARE | Not denied | — |
| CLM0003593 | 30 May 2025 | 556.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0003592 | 10 Feb 2025 | 87.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 87.00 |