ELENA SMITH
Subscriber on policy B05M000762
Claims
2
Attributed to this person
Charged
1,566.00
Total submitted
Denied
391.35
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 SMITH |
| Role on the policy | Subscriber |
| Policy | B05M000762 |
| Date of birth | 15 Feb 1991 |
| Plan | GOLD PPO |
| Covered from | 15 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 |
|---|---|---|---|---|---|
| CLM0003266 | 21 Feb 2026 | 847.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 391.35 |
| CLM0003267 | 30 Jul 2025 | 719.00 | MERIDIAN HEALTH PLAN | Not denied | — |