BRIAN FOSTER
Subscriber on policy B04M000801
Claims
2
Attributed to this person
Charged
711.00
Total submitted
Denied
122.09
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 | BRIAN FOSTER |
| Role on the policy | Subscriber |
| Policy | B04M000801 |
| Date of birth | 24 Jul 1979 |
| Plan | SILVER HMO |
| Covered from | 8 Apr 2024 |
| Covered to | 7 Aug 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 |
|---|---|---|---|---|---|
| CLM0003499 | 10 Jun 2024 | 427.00 | CASCADE CARE | Not denied | — |
| CLM0003500 | 2 May 2024 | 284.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 122.09 |