Policy B03M000795
5 people enrolled on this policy.
People
5
On this policy
Claims attributed
14
To a named person
Policy-level
0
Not attributed to a person
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.
People on this policy
| Name | Role | Born | Claims | Denials | Denied | Patient responsibility (835) |
|---|---|---|---|---|---|---|
| HENRY JOHNSON | Subscriber | 25 Jan 1971 | 3 | 1 | 666.00 | 0.00 |
| DAVID JOHNSON | Dependent · 01 | 21 Feb 1968 | 3 | 2 | 465.00 | 0.00 |
| VICTOR JOHNSON | Dependent · 19 | 9 Mar 2005 | 3 | 0 | 0.00 | 0.00 |
| GRACE JOHNSON | Dependent · 19 | 9 Jul 2009 | 3 | 2 | 1,415.00 | 0.00 |
| PRIYA JOHNSON | Dependent · 19 | 25 Mar 2011 | 2 | 1 | 562.00 | 0.00 |
Policy-level claims
Every claim on this policy is attributed to a named person.
Claims are attributed to a person from the patient loop of the 837P — name, date of birth and relationship within the policy — because the transaction carries no patient identifier. A claim that matches nobody, or more than one person, stays with the policy and is shown there rather than being assigned to a guess.