Will someone please help me with these two question. #1 You're an inpatient coder in a hospital. You've just coded a Medicare Part A record with a diagnosis-related group (DRG )reinbursement of $12,000. You notice in the hospital's computer billing system that the patient's chagres are $19,500. That's $7,500 more than the hospital will be reinburesd. How does the difference between the charges and the DRG reinbursement become resolved? #2 You're reviewing reinbursement for a Medicare surgical craniotomy case. The case falls into DRG1, which has a relative weight of 3.09070 and a geometric mean lenght of stay of 6.3. The hospital's current standard reinbursement rate is $1500. Calculate the DRG reinbursement for this case.

Please I really need help with these two. Thankyou for your time.

I have only a comment about #1 (no knowledge at all about #2):

For two years now, I've noticed HUGE differences between what my doctor, the lab, the radiology dept at the hospital, and the emergency clinic have billed Medicare. Apparently they have all contracted with Medicare to accept Medicare's opinion of what each service will cost, so they get paid only up to that much. Medicare pays part of the Medicare-approved amount, and the rest is paid either by the patient directly or by a secondary insurance he/she has.

What happens to the rest? I suppose it just gets written off. Or else the doctors, hospitals, etc., are billing higher for various procedures, knowing that Medicare will pay only some percentage. I'm not sure.