JULIA FOSTER
Dependent on policy B05M000430
Claims
1
Attributed to this person
Charged
77.00
Total submitted
Denied
31.72
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 | JULIA FOSTER |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000430 |
| Date of birth | 11 Jun 2014 |
| Plan | PLATINUM PPO |
| Covered from | 4 Sep 2024 |
| Covered to | 24 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001813 | 27 Nov 2024 | 77.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 31.72 |