CARLA CHEN
Dependent on policy B03M000676
Claims
3
Attributed to this person
Charged
1,488.00
Total submitted
Denied
619.00
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 | Dependent · relationship 01 |
| Policy | B03M000676 |
| Date of birth | 28 Oct 2008 |
| Plan | PLATINUM PPO |
| Covered from | 20 Mar 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0002807 | 28 Nov 2024 | 619.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 619.00 |
| CLM0002806 | 19 Jul 2024 | 411.00 | CASCADE CARE | Not denied | — |
| CLM0002805 | 12 May 2024 | 458.00 | CASCADE CARE | Not denied | — |