ELENA ANDERSON
Dependent on policy B05M000334
Claims
3
Attributed to this person
Charged
783.00
Total submitted
Denied
397.00
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 ANDERSON |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000334 |
| Date of birth | 3 Jan 1951 |
| Plan | PLATINUM PPO |
| Covered from | 28 Feb 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001419 | 19 Sep 2025 | 397.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 397.00 |
| CLM0001417 | 15 Feb 2025 | 297.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001418 | 14 Feb 2025 | 89.00 | NORTHSTAR MUTUAL | Not denied | — |