ZARA WILSON
Subscriber on policy B05M000789
Claims
3
Attributed to this person
Charged
895.00
Total submitted
Denied
404.61
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 | ZARA WILSON |
| Role on the policy | Subscriber |
| Policy | B05M000789 |
| Date of birth | 26 May 1982 |
| Plan | PLATINUM PPO |
| Covered from | 16 Oct 2024 |
| Covered to | 27 Dec 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 |
|---|---|---|---|---|---|
| CLM0003349 | 9 Feb 2025 | 390.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 390.00 |
| CLM0003350 | 9 Dec 2024 | 230.00 | CASCADE CARE | Not denied | — |
| CLM0003348 | 17 Nov 2024 | 275.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 14.61 |