KEVIN WILSON
Dependent on policy B03M000837
Claims
1
Attributed to this person
Charged
798.00
Total submitted
Denied
798.00
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 | KEVIN WILSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000837 |
| Date of birth | 16 Jul 2000 |
| Plan | SILVER HMO |
| Covered from | 13 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003615 | 17 Mar 2025 | 798.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 798.00 |