JULIA GARCIA
Dependent on policy B05M000398
Claims
3
Attributed to this person
Charged
295.00
Total submitted
Denied
142.98
2 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 GARCIA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000398 |
| Date of birth | 8 Sep 1988 |
| Plan | GOLD PPO |
| Covered from | 26 Jan 2024 |
| Covered to | 9 May 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 |
|---|---|---|---|---|---|
| CLM0001698 | 14 May 2024 | 80.00 | CASCADE CARE | Not denied | — |
| CLM0001699 | 26 Feb 2024 | 105.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 32.98 |
| CLM0001700 | 16 Jan 2024 | 110.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 110.00 |