WENDY HUGHES
Dependent on policy B04M000635
Claims
3
Attributed to this person
Charged
1,472.00
Total submitted
Denied
206.02
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 | WENDY HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000635 |
| Date of birth | 24 Oct 2003 |
| Plan | PLATINUM PPO |
| Covered from | 23 Apr 2024 |
| Covered to | 20 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 |
|---|---|---|---|---|---|
| CLM0002760 | 16 Sep 2024 | 477.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 206.02 |
| CLM0002759 | 29 Jul 2024 | 447.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002761 | 25 Apr 2024 | 548.00 | NORTHSTAR MUTUAL | Not denied | — |