⚠️TEST CLINIC — Maria Lahti Cardiology — Demo Data Only⚠️

Insurance Eligibility

Eligibility verification and coverage details for clinic patients

3

BlueCross BlueShield

2

United Healthcare

2

Aetna

2

Medicaid

1

Medicare Part B

1

Medicare Part A

1

Self-Pay

James Morrison

Active
BlueCross BlueShield(PPO)
Checked: 2026-03-19

Member ID

BCB-445521890

Copay

$40

Deductible

$1,500

Deductible Met

$1,500 (Met)

Coinsurance

80/20

OOP Max

$6,000

OOP Met

$3,200

Effective

2026-01-01

Specialist copay applies

William Jackson

Active
Medicare Part B(Medicare)
Checked: 2026-03-19

Member ID

1EG4-TE5-MK72

Copay

$0

Deductible

$240

Deductible Met

$240 (Met)

Coinsurance

80/20

OOP Max

N/A

OOP Met

N/A

Effective

2022-07-01

Medicare covers 80% after deductible

Patricia Kowalski

Active
United Healthcare(HMO)
Checked: 2026-03-18

Member ID

UHC-998877665

Copay

$35

Deductible

$2,000

Deductible Met

$1,400

Coinsurance

70/30

OOP Max

$7,500

OOP Met

$2,800

Effective

2026-01-01

Referral required for specialist

Carlos Reyes

Active
Aetna(EPO)
Checked: 2026-03-19

Member ID

AET-332211009

Copay

$45

Deductible

$1,750

Deductible Met

$0

Coinsurance

80/20

OOP Max

$6,500

OOP Met

$0

Effective

2026-03-01

New coverage effective March 2026

Eleanor Whitfield

Active
Medicare Part A(Medicare)
Checked: 2026-03-18

Member ID

1EG4-WH1-EL86

Copay

$0

Deductible

$1,632

Deductible Met

$1,632 (Met)

Coinsurance

100% days 1-60

OOP Max

N/A

OOP Met

N/A

Effective

2020-03-01

Inpatient benefit period active. TAVR covered.

Robert Chen

Active
BlueCross BlueShield(PPO)
Checked: 2026-03-17

Member ID

BCB-778899001

Copay

$40

Deductible

$1,500

Deductible Met

$1,500 (Met)

Coinsurance

80/20

OOP Max

$6,000

OOP Met

$4,100

Effective

2026-01-01

Margaret Sullivan

Active
Medicaid(Medicaid)
Checked: 2026-03-17

Member ID

FLM-5544332211

Copay

$0

Deductible

$0

Deductible Met

N/A

Coinsurance

100%

OOP Max

N/A

OOP Met

N/A

Effective

2025-10-01

No cost sharing. Prior auth may be needed.

Thomas Williams

Active
BlueCross BlueShield(PPO)
Checked: 2026-03-16

Member ID

BCB-112233445

Copay

$40

Deductible

$2,000

Deductible Met

$2,000 (Met)

Coinsurance

80/20

OOP Max

$7,000

OOP Met

$5,500

Effective

2026-01-01

Cardiac rehab covered at 80%

Dorothy Hayes

Active
United Healthcare(PPO)
Checked: 2026-03-15

Member ID

UHC-665544332

Copay

$50

Deductible

$1,500

Deductible Met

$1,200

Coinsurance

80/20

OOP Max

$6,000

OOP Met

$2,400

Effective

2026-01-01

Maria Santos

Active
Medicaid(Medicaid)
Checked: 2026-03-14

Member ID

FLM-8877665544

Copay

$0

Deductible

$0

Deductible Met

N/A

Coinsurance

100%

OOP Max

N/A

OOP Met

N/A

Effective

2025-06-01

MitraClip prior auth denied. Appeal in progress.

Mildred Brooks

Active
Aetna(PPO)
Checked: 2026-03-01

Member ID

AET-998877001

Copay

$40

Deductible

$1,500

Deductible Met

$1,500 (Met)

Coinsurance

80/20

OOP Max

$5,500

OOP Met

$4,200

Effective

2026-01-01

ICD implant covered

Roberto Espinoza

Active
Self-Pay(Self-Pay)
Checked: 2026-03-07

Member ID

N/A

Copay

N/A

Deductible

N/A

Deductible Met

N/A

Coinsurance

N/A

OOP Max

N/A

OOP Met

N/A

Effective

N/A

Sliding scale payment plan established. $150/visit.