CARLA FOSTER
Subscriber on policy B05M000169
Claims
2
Attributed to this person
Charged
1,444.00
Total submitted
Denied
848.00
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 | CARLA FOSTER |
| Role on the policy | Subscriber |
| Policy | B05M000169 |
| Date of birth | 3 Mar 1990 |
| Plan | BRONZE EPO |
| Covered from | 4 Aug 2024 |
| Covered to | 6 Oct 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 |
|---|---|---|---|---|---|
| CLM0000713 | 11 Oct 2024 | 848.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 848.00 |
| CLM0000712 | 14 Sep 2024 | 596.00 | CASCADE CARE | Not denied | — |