Member

Member ID: 53252345-01

Member ID	Effective Date	Name	Group ID	Relationship
53252345-01	01/01/2009	Sue Brown	G1234	Wife
532523450-00	01/01/2017	Sue George	G2345	Subscriber
183245602-01	01/01/1999	Sue George	G2130	Wife
332100450-03	03/01/1990	Sue Johnson	G2000	Daughter
4 Member Coverages

Name: Brown, Sue

Relationship: Wife

DOB: 01/01/1972

Group: G1234

Eff. Date: 01/01/2009

External ID: 9896695

Other Family Members: Yes

Auths/Referrals Exist: Yes

Claims Exist: Yes

Student Handicap: NA

Quick View: Notes,

Attachments

Billing Related Details: NA

FSA Health: $1,000

FSA Dependent: $1,000

HRA Family: $750

HRA Member: $500

Member journey as of:

Member Coverage Info

Member ID:	53252345-01
Group:	G1234 - Acme Home Insurance
Subgroup:	S1234 - Acme Home Insurance Subgroup One
Orig Effective Date:	01/01/2009
Class:	AC - Active Class
Relationship:	Wife

Eligible Plans(Billing Eligible Only)

Medical:	WDWM
Dental:	WDWD
Chiropractic:	WDWC

Other Family Members

Relationship	Name	DOB	BILLING Eligible Only
Subscriber	Brown, Tom Encounter Hospital Processing Medical Agreement Configurator FSA Claims Processing Hospital Claims Processing Medical Claims Processing Hospital Claims Logging / History Hospital Claims Pre-Pricing Medical Claims Logging / History Medical Claims Pre-Pricing Member and Fam Accums Payment Open Claim Checks Open FSA Claim Checks Dental Claims Processing Agreement, Medical Agreement, Dental Modifier Pricing Rules	01/01/1972	M, D
Daughter	Brown, Mary Encounter Hospital Processing Medical Agreement Configurator FSA Claims Processing Hospital Claims Processing Medical Claims Processing Hospital Claims Logging / History Hospital Claims Pre-Pricing Medical Claims Logging / History Medical Claims Pre-Pricing Member and Fam Accums Payment Open Claim Checks Open FSA Claim Checks Dental Claims Processing Agreement, Medical Agreement, Dental Modifier Pricing Rules	01/01/2010	M, D
Son	Brown, John Encounter Hospital Processing Medical Agreement Configurator FSA Claims Processing Hospital Claims Processing Medical Claims Processing Hospital Claims Logging / History Hospital Claims Pre-Pricing Medical Claims Logging / History Medical Claims Pre-Pricing Member and Fam Accums Payment Open Claim Checks Open FSA Claim Checks Dental Claims Processing Agreement, Medical Agreement, Dental Modifier Pricing Rules	01/01/2011	M, D

Primary Care Providers

Medical Primary:

COYNE - Thomas, Marcus C.

Coordination of Benefits

Commercial - Medical - Primary:	BCBS (Policy: 3452346364)
Commercial - Dental - Primary:	UHG (Policy: 9452346388)

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