AMARA WILSON
Dependent on policy B03M000486
Claims
3
Attributed to this person
Charged
1,279.00
Total submitted
Denied
4.96
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 | AMARA WILSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000486 |
| Date of birth | 18 Jul 1945 |
| Plan | SILVER HMO |
| Covered from | 27 May 2024 |
| Covered to | 3 Dec 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 |
|---|---|---|---|---|---|
| CLM0002028 | 24 Sep 2024 | 514.00 | CASCADE CARE | Not denied | — |
| CLM0002027 | 14 Sep 2024 | 289.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 4.96 |
| CLM0002026 | 2 Jul 2024 | 476.00 | CASCADE CARE | Not denied | — |