RAVI PATEL
Dependent on policy B05M000562
Claims
2
Attributed to this person
Charged
256.00
Total submitted
Denied
256.00
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 | RAVI PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000562 |
| Date of birth | 16 Aug 1981 |
| Plan | BRONZE EPO |
| Covered from | 15 Dec 2024 |
| Covered to | 23 Feb 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 |
|---|---|---|---|---|---|
| CLM0002404 | 17 Feb 2025 | 115.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 115.00 |
| CLM0002403 | 7 Dec 2024 | 141.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 141.00 |