Claim Summary
{{preloginError}}
Select Plan
{{item.product.codeDesc}}
{{" " + oneError}}
Search Claims
{{validationError}}
{{summarymemberClaim.fromdate}}
{{summarymemberClaim.todate}}
Show Pre Treatment Estimate
Claim List
{{claim.error}}
{{oneError}}
{{thresholdIndicatorError}}
{{claimsErrorEobIdRequest}}
{{eoberror}}
| Dentist Name | Office Location | Date of Service | Subscriber ID | Member | Amount Claimed | Claim Status | View |
|---|---|---|---|---|---|---|---|
| {{item.provider.providerName.lastName}}, {{item.provider.providerName.firstName}} | {{item.dateOfService.startDate | date : "MM/dd/yyyy"}} | {{item.member.memberId | maskNumber }} | {{item.member.name.lastName}}, {{item.member.name.firstName}} | $ {{(item.totalAmountPayable == undefined) ? '0.00' : item.totalAmountPayable}} |
{{item.claimStatusCode.codeDesc}} | EOB/ |
Pre Treatment Estimate List
{{claimsErrorPte }}
| Date Received | Subscriber ID | Member | Dentist Name | Office Location | Claim Status | Submitted Charges | View |
|---|---|---|---|---|---|---|---|
| {{item.processedDate | date : "MM/dd/yyyy"}} | {{item.member.memberId |maskNumber}} | {{item.member.name.lastName}}, {{item.member.name.firstName}} | {{item.provider.providerName.lastName}}, {{item.provider.providerName.firstName}} | {{item.claimStatusCode.codeDesc}} | $ {{(item.totalCharge == undefined) ? '0.00' : item.totalCharge}} |