General Claims
ID: 800065319
This is Robert Rapp, my DOB is 08/14/1967
I just want to see how my most recent claim for my doctor I went to on 04/15/25 paid out. The billed amount should be $274.00
At this time this is put into Jeopardy, this claim is still in the Claim Pended; Awaiting Batch status and we can't quote these yet because the claim is pending or in process. Refer to the Claim Status handout in your Basic Training folder. Basic Training > Post Service > Claims > Claim Status
If the claim has processed, walk through the claim quoting together.
ID: 800383608
Hi, this is Sckyler Goodwin...I know... Clearly I live in Utah. Can we go back in time really quick and go over a claim because I got a bill for counseling and want to know why? The Date of Service is 03/20/2023 and it was for $150.00 bucks
Looking at the Line Item Details, this claim denied because the provider is Not contracted to perform this service. Looking at the Explanation Code Lookup tool, the Disallow code ZCM associated with this shows that it is the providers responsibility. Call the provider and make sure they understand the reason for the denial.
ID: 802821518
Hey there, this is Beth calling from Exact Sciences Laboratories LLC. I just wanted some claim information for a recent visit with Denee Murray, DOB 12/16/1975. The Date of Service is: 01/02/2025 and billed amt is $681.00
I need:
1. The allowed/paid amounts
2. Any member responsibility
3. If there were any denials
4. Was this paid as an EFT or Manual check?
5. Was the check a Single or Bulk payment?
6. What was the check amount?
7. What was the payment date?
8. What was the Check/EFT number associated?
1. Allowed & Paid = $508.87
2. No Member Responsibility
3. No denials
4. This was paid as an EFT
5. This was a bulk payment
6. Total was $16,792.71
7. Payment date was 01/15/25
8. EFT Number is: 25015B1000150254
ID: 80194338
Hi, I'm Alisa Morgan my DOB is 10/07/1966 and I just want to know some basic claim info for my daughter Chelsea Morgan, DOB 04/15/2011
DOS: 03/12/2025
AMT: $290.00
Allowed: $218.21
Paid: $174.57
Coinsurance: $43.64 (member responsibility)
ID: 801776635
Hello, this is Laurie Salisbury, DOB 02/05/1977
I just need to know if I have pay anything on a claim for a visit to Tellica Imaging. Date of service is: 04/05/2025 and Billed Amt is: $600.00
Allowed amount is $500 dollars, leaving a $100 dollar copay for the member responsibility based off of her benefits.
ID: 801864683
Hello, my name is Roger from IHC Billing. Phone number 801-555-1234. I just want some general claim information for member Chelsea Thornton, DOB 01/07/1983
I just need the allowed amount and what the member responsibility is if there's any - The DOS is 03/02/2025 and billed amount is $6,765.75
Allowed: $5,173
All processed towards this member's deductible as their responsibility
ID# 800982032
This is Julie Jackson, DOB 10/12/1975.
I need to know what my responsibility is on a claim for my daughter, Vivian. DOB 08/26/2007.
DOS 04/14/2025.
Billed $190.00
Allowed: $170.06
Paid: $150.06
Member responsibility is $20.00 which was the copay amount
ID# 802697063
This is Mikaela Rane, DOB 01/17/1990.
I don’t understand this EOB, what do I owe for this visit?
DOS: 10/30/2024
Billed: $200.00
Allowed: $112.29
Paid:$67.29
Copay: $45.00
ID: 802739369
This is Karla from Labcorp Phoenix: Callback 565-282-1238
I just need to know how a claim processed: DOS: 02/05/2025 - Billed: $1,016.72
ID# 802617286
Bart Palmer, here, DOB 05/02/1973.
Hey, how did this claim process on my policy?
DOS: 04/22/2024
Billed: $178.03
Allowed: $132.14
Paid: $0.00
Deductible: $132.14
ID: 800982032
Hey! My name is Samuel R Jackson, and I'm a feisty teenager trying to find out why I got a bill from you guys. My DOB is 09/22/2008
The DOS is 04/17/2025 and billed amount is $245.13
Allowed: $185.34
Paid: $185.34
No member responsibility
ID# 802109777
This is Roberta calling from McKay Dee Hospital, callback 801-538-8712.
How did this claim process for Tashina Palmer, DOB 12/24/1987.
DOS: 04/08/2024
Billed: $50,048.04
Allowed: $14,912.98
Paid: $11,187.36
Deductible: $1,475.62
Coinsurance: $2,250.00
Bonus Points: Why is there both a deductible and Coinsurance amount? And why is the deductible lower?
ID: 802739372
Hi, my name is Olivia Thompson and my DOB is 11/11/2004 at 11:11pm. I just wanted to make sure a claim from my therapist went through okay, can you go over it with me? The Date of Service is 04/17/25 and billed amount is $300.00
Allowed: $112.65
Paid: $112.65
No member responsibility
ID: 803011825
Hey, my name is Savannah Patino, DOB 12/19/2007. I just got a huge bill from St. Marks saying that I owe them like 5 grand. Is that true? Can you look at it with me? It say on the bill the Date of Service is 03/17/2025 and total billed amount is $5,995.05
Allowed: $5,437.00
Paid: $747.99
Deductible: $4,689.01
ID: 802972498
Hello, this is Jamie from Dr. Michelle Bailey's office. I just want to check on a claim from one of your members Adam Petersen, DOB 07/04/1991. We never got a payment from you so can you review this with me to see why? Did it deny?
The Date of Service is 05/16/2024
Billed amt is: $204.91
Allowed: $137.22
Paid: $0.00
Deductible: $137.22 - All member responsibility