WENDY BAKER
Subscriber on policy B03M000556
Claims
1
Attributed to this person
Charged
707.00
Total submitted
Denied
707.00
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 | WENDY BAKER |
| Role on the policy | Subscriber |
| Policy | B03M000556 |
| Date of birth | 8 Dec 1979 |
| Plan | BRONZE EPO |
| Covered from | 23 Jun 2024 |
| Covered to | 13 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002273 | 25 Oct 2024 | 707.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 707.00 |