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Hello- Please help! INSTRUCTIONS Calculate the amounts paid by the payer and the

ID: 457669 • Letter: H

Question

Hello-

Please help!

INSTRUCTIONS

Calculate the amounts paid by the payer and the patient and the amount the provider must “write off”.

The patient undergoes arthroscopic surgery at an ambulance surgical center. The surgeon’s fee is $890. The patient’s coinsurance is 20% of the $700 fee schedule, and the patient is not required to pay any additional amount to the provider. The payer reimburses the surgeon 80% of the $700 fee schedule.

Enter the amount the patient pays the provider:                      __________

Enter the amount the payer reimburses the provider: __________

Enter the amount the provider “writes off” the account:         __________

Explanation / Answer

Coinsurance is the percentage of costs a patient shares with the health plan. If the coinsurance is 20% of $700, than the patient pays 0.2*700 = $140 to the service provider. And the remaining 80%, that is, 08.*700 = $560 is reimbursed to service provider. Then any amount remains after payment by the patient and 80% reimbursement, it is “written off” in the account by the provider.

Enter the amount the patient pays the provider:   20% of $700 = $140

Enter the amount the payer reimburses the provider:80% of $700 = $560

Enter the amount the provider “writes off” the account: $890 - $700 = $190