AMARA WILSON
Subscriber on policy B04M000559
Claims
2
Attributed to this person
Charged
833.00
Total submitted
Denied
148.00
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 | AMARA WILSON |
| Role on the policy | Subscriber |
| Policy | B04M000559 |
| Date of birth | 13 Feb 1994 |
| Plan | PLATINUM PPO |
| Covered from | 1 Aug 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 |
|---|---|---|---|---|---|
| CLM0002454 | 5 Sep 2024 | 685.00 | CASCADE CARE | Not denied | — |
| CLM0002453 | 28 Jul 2024 | 148.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 148.00 |