FIONA CHEN
Subscriber on policy B03M000387
Claims
2
Attributed to this person
Charged
1,163.00
Total submitted
Denied
165.54
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 | FIONA CHEN |
| Role on the policy | Subscriber |
| Policy | B03M000387 |
| Date of birth | 10 Feb 1990 |
| Plan | GOLD PPO |
| Covered from | 10 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001565 | 6 Jun 2025 | 351.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 165.54 |
| CLM0001564 | 26 Feb 2025 | 812.00 | NORTHSTAR MUTUAL | Not denied | — |