X12 Ingest & Denial Analytics

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Members›policy B03M000187›ELENA PATEL

ELENA PATEL

Dependent on policy B03M000187

Claims
2
Attributed to this person
Charged
1,034.00
Total submitted
Denied
1,034.00
2 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

FieldValue
NameELENA PATEL
Role on the policyDependent · relationship 01
PolicyB03M000187
Date of birth4 Nov 1978
PlanGOLD PPO
Covered from30 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000076517 Sep 2025402.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY402.00
CLM00007642 May 2025632.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY632.00