KEVIN CHEN
Dependent on policy B05M000261
Claims
1
Attributed to this person
Charged
166.00
Total submitted
Denied
166.00
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 | KEVIN CHEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000261 |
| Date of birth | 5 Jan 1982 |
| 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 |
|---|---|---|---|---|---|
| CLM0001088 | 26 Feb 2024 | 166.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 166.00 |