MARCUS PATEL
Dependent on policy B06M000158
Claims
2
Attributed to this person
Charged
676.00
Total submitted
Denied
73.00
1 denied claims
Patient responsibility
90.45
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 | MARCUS PATEL |
| Role on the policy | Dependent · relationship 01 |
| Policy | B06M000158 |
| Date of birth | 1 Mar 1966 |
| Plan | GOLD PPO |
| Covered from | 1 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 90.45 |
| Total | 90.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000788 | 27 Nov 2024 | 73.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 73.00 |
| CLM0000787 | 4 Nov 2024 | 603.00 | MERIDIAN HEALTH PLAN | Not denied | — |