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, and the patient is not required to pay any additional amount to the provider. The payer reimburses the physician $28.
1. How much does the patient pays the provider? $20 (as stated in the question)
2. How much does the payer reimburse the provider? $28 (as stated in the question)
3. How much does provider write off? $27 (after adding the copayment and reimbursement, I subtract the total from $75, which gives me $27 for the write-off)
Are the answers correct? If not, could you please help explain how to figure out the correct amounts.
Yes, all are correct.
1. Correct, the patient pays the provider $20 as their copayment.
2. Correct, the payer reimburses the provider $28 as the agreed upon reimbursement amount.
3. The calculation for the write-off amount is incorrect. To determine the write-off, subtract the total amount reimbursed by the payer from the provider's fee. In this case, the provider's fee is $75, and the reimbursement is $28. So the write-off amount would be $75 - $28 = $47.
Therefore, the correct answer for the write-off amount is $47.
To summarize:
- The patient pays $20.
- The payer reimburses the provider $28.
- The provider writes off $47.
The answers provided are not correct. Allow me to explain how to calculate the correct amounts.
1. To determine how much the patient pays the provider, we need to subtract the copayment from the provider's fee. In this case, the provider's fee is $75 and the copayment is $20. Therefore, the patient pays $75 - $20 = $55 to the provider.
2. The payer reimburses the provider $28. This means that the insurance company pays $28 to the provider as a reimbursement for the services provided.
3. The write-off amount refers to the difference between the provider's fee and the total amount received from the patient and payer. To calculate the write-off, subtract the amount received from the patient and the amount received from the payer from the provider's fee. In this case, the provider's fee is $75, the patient paid $55, and the payer reimbursed $28. Therefore, the write-off amount would be $75 - $55 - $28 = -$8.
Note that a negative write-off indicates that the physician is not being fully reimbursed for their services. It means that they are accepting a lower payment than their fee or writing off a portion of the amount owed.