FIONA SMITH
Subscriber on policy B01M000831
Claims
1
Attributed to this person
Charged
450.00
Total submitted
Denied
450.00
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 | FIONA SMITH |
| Role on the policy | Subscriber |
| Policy | B01M000831 |
| Date of birth | 8 Jul 2001 |
| Plan | PLATINUM PPO |
| Covered from | 27 May 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 |
|---|---|---|---|---|---|
| CLM0003687 | 5 Oct 2024 | 450.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 450.00 |