HENRY HUGHES
Subscriber on policy B04M000366
Claims
1
Attributed to this person
Charged
378.00
Total submitted
Denied
378.00
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 HUGHES |
| Role on the policy | Subscriber |
| Policy | B04M000366 |
| Date of birth | 9 Dec 1983 |
| Plan | GOLD PPO |
| Covered from | 3 Jul 2024 |
| Covered to | 25 Sep 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 |
|---|---|---|---|---|---|
| CLM0001565 | 1 Jul 2024 | 378.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 378.00 |