KEVIN SMITH
Subscriber on policy B05M000001
Claims
2
Attributed to this person
Charged
563.00
Total submitted
Denied
108.98
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 | KEVIN SMITH |
| Role on the policy | Subscriber |
| Policy | B05M000001 |
| Date of birth | 19 Dec 1954 |
| Plan | BRONZE EPO |
| Covered from | 7 Feb 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 |
|---|---|---|---|---|---|
| CLM0000007 | 4 Nov 2024 | 308.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 108.98 |
| CLM0000006 | 14 Jun 2024 | 255.00 | MERIDIAN HEALTH PLAN | Not denied | — |