Fill out the information below and determine the amount owed by the patient afte
ID: 2342630 • Letter: F
Question
Fill out the information below and determine the amount owed by the patient after deductible has been met in the following situations. Provide the calculations used to determine your answers:
A. Participating physician’s standard fee: $300.00
Allowed amount $200.00
Medicare pays 80%
Patient or supplemental plan pays 20%:
Provider adjustment (write-off):
B. Nonpar physician’s standard fee (accepts assignment): $250.00
MFS: $200
Medicare nonpar fee:
Medicare pays 80%:
Patient or supplemental plan pays 20%:
Provider adjustment (write-off):
C. Nonpar physician’s standard fee (does not accept assignment): $250.00
MFS: $200
Medicare nonpar fee:
Limiting charge :
Patient billed:
Medicare pays patient:
Total provider can collect:
Patient out-of-pocket expense:
Provider adjustment (write-off):
Explanation / Answer
A.Ans:
Participating Physician's standard fee:$300
Allowed Amount $200
Medicare Pays 80% -$160
Patient or Supplemental Plan Pays 20% - $40
Provider Adjustment(write-off)=$100
B.Non Par Physician's Standard Fee(Accepts Assignment):$250
MFS: $200
Medicare nonpar fee: 95%=$190
Medicare pays 80%: $152
Patient or supplemental plan pays 20%:$38+ $10=$48
Provider adjustment (write-off): $50
C.Non Par Physician's Standard Fee(Does not accept Assignment) :$250
MFS:$200
Medicare Non par Fee 109.25% above par fee:$218.50
Limiting Charge:115%
Patient Billed:
Medicare Pays Patient(80% of 218.50):174.80
Total Provider can collect:218.50
Patient Out of Pocket expenses(20%):$43.70
Provider Adjustment(Write-off) :$31.50
Related Questions
drjack9650@gmail.com
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.