ELENA PATEL
Subscriber on policy B03M000610
Claims
3
Attributed to this person
Charged
1,966.00
Total submitted
Denied
475.00
1 denied claims
Patient responsibility
96.15
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 | ELENA PATEL |
| Role on the policy | Subscriber |
| Policy | B03M000610 |
| Date of birth | 11 Jan 1976 |
| Plan | GOLD PPO |
| Covered from | 10 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 96.15 |
| Total | 96.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002510 | 28 Sep 2025 | 641.00 | CASCADE CARE | Not denied | — |
| CLM0002508 | 1 Jan 2025 | 475.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 475.00 |
| CLM0002509 | 20 Oct 2024 | 850.00 | CASCADE CARE | Not denied | — |