HENRY BAKER
Subscriber on policy B04M000685
Claims
1
Attributed to this person
Charged
712.00
Total submitted
Denied
712.00
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 | HENRY BAKER |
| Role on the policy | Subscriber |
| Policy | B04M000685 |
| Date of birth | 16 Sep 1960 |
| Plan | GOLD PPO |
| Covered from | 19 Apr 2024 |
| Covered to | 25 Oct 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 |
|---|---|---|---|---|---|
| CLM0002988 | 23 Nov 2024 | 712.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 712.00 |