PRIYA REYES
Subscriber on policy B03M000147
Claims
2
Attributed to this person
Charged
290.00
Total submitted
Denied
71.00
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 | PRIYA REYES |
| Role on the policy | Subscriber |
| Policy | B03M000147 |
| Date of birth | 23 Apr 1968 |
| Plan | PLATINUM PPO |
| Covered from | 5 Jan 2024 |
| Covered to | 13 Mar 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 |
|---|---|---|---|---|---|
| CLM0000604 | 22 Mar 2024 | 71.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 71.00 |
| CLM0000603 | 5 Mar 2024 | 219.00 | CASCADE CARE | Not denied | — |