ELENA USMAN
Subscriber on policy B05M000088
Claims
1
Attributed to this person
Charged
348.00
Total submitted
Denied
348.00
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 USMAN |
| Role on the policy | Subscriber |
| Policy | B05M000088 |
| Date of birth | 15 Dec 1964 |
| Plan | BRONZE EPO |
| Covered from | 16 Jun 2024 |
| Covered to | 27 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 |
|---|---|---|---|---|---|
| CLM0000394 | 30 May 2024 | 348.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 348.00 |