FIONA GARCIA
Dependent on policy B05M000779
Claims
1
Attributed to this person
Charged
298.00
Total submitted
Denied
298.00
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 | FIONA GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000779 |
| Date of birth | 14 Nov 1957 |
| Plan | GOLD PPO |
| Covered from | 24 Aug 2024 |
| Covered to | 8 Dec 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 |
|---|---|---|---|---|---|
| CLM0003323 | 15 Dec 2024 | 298.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 298.00 |