1. The patient is seen by his family physician for follow-up treatment of recently diagnosed asthmatic bronchitis. The physician’s fee is $75. The patient’s copayment is $20. The patient’s insurance plan covers 80% of the fee schedule amount of $60. No deductible is required.
a. Enter the amount the patient pays the provider: __________________
b. Enter the amount the payer reimburses the provider: ______________
c. Enter the amount the provider “writes off” the account: ____________
I don't just want the answer given to me I want help to understand how to get each question answered
a. patient pays 20
b. provider pays .80*60=48
total paid= 68
provider billed to patient 75
"write off"=75-68=7 dollars
To answer these questions, you need to understand how each payment and reimbursement is calculated based on the given information. Let's break it down step by step:
a. Enter the amount the patient pays the provider:
To calculate this amount, you need to consider the patient's copayment and the portion of the fee not covered by insurance.
1. Start by subtracting the insurance coverage from the fee schedule amount:
$60 (fee schedule amount) x 0.8 (insurance coverage) = $48
2. Then subtract the patient's copayment from that amount:
$48 - $20 (copayment) = $28
Therefore, the amount the patient pays the provider is $28.
b. Enter the amount the payer reimburses the provider:
This amount is the remaining portion of the fee after the patient's payment.
1. Start with the fee schedule amount:
$60
2. Deduct the patient's copayment:
$60 - $20 (copayment) = $40
3. Deduct the patient's payment based on the insurance coverage:
$40 - $28 (patient payment) = $12
Therefore, the amount the payer reimburses the provider is $12.
c. Enter the amount the provider "writes off" the account:
The "write-off" amount refers to the difference between the provider's fee and the amount the payer reimburses, which the provider does not collect from the patient.
1. Start with the provider's fee:
$75
2. Deduct the amount reimbursed by the payer:
$75 - $12 (reimbursement) = $63
Therefore, the amount the provider "writes off" the account is $63.
In summary:
a. The patient pays the provider $28.
b. The payer reimburses the provider $12.
c. The provider "writes off" $63.