CARLA HUGHES
Dependent on policy B06M000454
Claims
2
Attributed to this person
Charged
862.00
Total submitted
Denied
787.00
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 | CARLA HUGHES |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000454 |
| Date of birth | 4 Dec 2013 |
| Plan | SILVER HMO |
| Covered from | 4 Apr 2024 |
| Covered to | 9 Jul 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 |
|---|---|---|---|---|---|
| CLM0002061 | 28 May 2024 | 75.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002062 | 15 May 2024 | 787.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 787.00 |