ELENA CHEN
Subscriber on policy B05M000261
Claims
1
Attributed to this person
Charged
899.00
Total submitted
Denied
899.00
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 CHEN |
| Role on the policy | Subscriber |
| Policy | B05M000261 |
| Date of birth | 15 Feb 1979 |
| Plan | PLATINUM PPO |
| Covered from | 6 Jan 2024 |
| Covered to | 16 Sep 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 |
|---|---|---|---|---|---|
| CLM0001087 | 11 Dec 2023 | 899.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 899.00 |