1. Assume that her average charge is $120 (before Medicare's limiting charge is applied), for which the average Medicare-approved amount is $100. If she decides to be a non-participating physician, she expects to accept assignment 80% of the time. For the unassigned patients assume that she would set her charges at 110% of the Medicare-approved fee for a nonparticipating physician. Assume that her Medicare patient volume is not reduced if she chooses not to participate nor if she does not accept assignment.

Case Study: What will be Dr. Rose's average reimbursement per visit if she chooses to be a Medicare-participating physician? (This is the total from both Medicare and the patients.)

HOW IS THIS CALCULATED?