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5. Use the information in the table below to answer the following questions: Payer Charge Payment Rate Volume Expected Revenue Medicare $250 Medicaid $250 Health

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5. Use the information in the table below to answer the following questions: Payer Charge Payment Rate Volume Expected Revenue Medicare $250 Medicaid $250 Health Plan 1 $250 Health Plan 2 $250 Health Plan 3 $250 Uninsured $250 $95 $75 $110 80% of charge $95 10% of charge 400 200 300 100 200 100 (a). Calculate the expected revenue for each payer. (b). What is the basis of payment (Cost, Fee Schedule or Price-related) for each payer? {c}. From the three commercial payers (Health Plan 1, 2, 3), which contract should be the first to be re-negotiated and why? Give a full, logical and informed explanation for your choice. (d). What is the payer mix when based on volume? (e). What is the payer mix when based on expected revenue? (Note payer mix is expressed as a percentage of total, where the sum of all payers is 100%). Present your final answers in the table below. Provide additional explanation and calculations to clearly demonstrate your logic (outside of the table). Payer (d) (a) Expected Revenue (b) Basis of Payment (e) Payer Mix Payer Mix (by volume) (by Revenue Medicare Medicaid Health Plan 1 Health Plan 2 Health Plan 3 Uninsured 5. Use the information in the table below to answer the following questions: Payer Charge Payment Rate Volume Expected Revenue Medicare $250 Medicaid $250 Health Plan 1 $250 Health Plan 2 $250 Health Plan 3 $250 Uninsured $250 $95 $75 $110 80% of charge $95 10% of charge 400 200 300 100 200 100 (a). Calculate the expected revenue for each payer. (b). What is the basis of payment (Cost, Fee Schedule or Price-related) for each payer? {c}. From the three commercial payers (Health Plan 1, 2, 3), which contract should be the first to be re-negotiated and why? Give a full, logical and informed explanation for your choice. (d). What is the payer mix when based on volume? (e). What is the payer mix when based on expected revenue? (Note payer mix is expressed as a percentage of total, where the sum of all payers is 100%). Present your final answers in the table below. Provide additional explanation and calculations to clearly demonstrate your logic (outside of the table). Payer (d) (a) Expected Revenue (b) Basis of Payment (e) Payer Mix Payer Mix (by volume) (by Revenue Medicare Medicaid Health Plan 1 Health Plan 2 Health Plan 3 Uninsured

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