ELENA CHEN
Subscriber on policy B03M000791
Claims
2
Attributed to this person
Charged
808.00
Total submitted
Denied
680.00
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 | ELENA CHEN |
| Role on the policy | Subscriber |
| Policy | B03M000791 |
| Date of birth | 18 Apr 1955 |
| Plan | GOLD PPO |
| Covered from | 18 Apr 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 |
|---|---|---|---|---|---|
| CLM0003365 | 6 Apr 2025 | 680.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 680.00 |
| CLM0003366 | 26 Jan 2025 | 128.00 | CASCADE CARE | Not denied | — |