CARLA CHEN
Subscriber on policy B01M000746
Claims
1
Attributed to this person
Charged
206.00
Total submitted
Denied
206.00
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 | CARLA CHEN |
| Role on the policy | Subscriber |
| Policy | B01M000746 |
| Date of birth | 22 Jan 1985 |
| Plan | GOLD PPO |
| Covered from | 30 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 |
|---|---|---|---|---|---|
| CLM0003315 | 15 Jan 2025 | 206.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 206.00 |