ELENA BAKER
Subscriber on policy B04M000295
Claims
3
Attributed to this person
Charged
1,286.00
Total submitted
Denied
414.00
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 BAKER |
| Role on the policy | Subscriber |
| Policy | B04M000295 |
| Date of birth | 8 Nov 1980 |
| Plan | BRONZE EPO |
| Covered from | 20 Nov 2024 |
| Covered to | 5 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001273 | 6 Mar 2025 | 414.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 414.00 |
| CLM0001274 | 24 Feb 2025 | 386.00 | CASCADE CARE | Not denied | — |
| CLM0001275 | 24 Nov 2024 | 486.00 | CASCADE CARE | Not denied | — |