LEILA QUINN
Dependent on policy B01M000447
Claims
2
Attributed to this person
Charged
947.00
Total submitted
Denied
153.00
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 | LEILA QUINN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000447 |
| Date of birth | 1 Apr 1972 |
| Plan | SILVER HMO |
| Covered from | 12 Jun 2024 |
| Covered to | 16 Sep 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 |
|---|---|---|---|---|---|
| CLM0001993 | 21 Aug 2024 | 794.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001992 | 21 May 2024 | 153.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 153.00 |