12. Our Aetna contract states that we are to be reimbursed $700 per MRI scan. An Aetna...
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12. Our Aetna contract states that we are to be reimbursed $700 per MRI scan. An Aetna cardholder comes to the hospital to have one MRI done on January 1 (the start of the patient's benefit year), and no other charges are billed to the plan the entire month of January. The patient has a $500 deductible and a 10% coinsurance that applies until he reaches his maximum out of pocket amount of $2,000. a. What is the amount we expect Aetna to allow? b. For this charge, what amount should Aetna remit as cash payment? How much will the patient owe?
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