. Audrey Appel, who is covered by Medicare as well as a Medigap policy, is a new patient of Dr. Augustino. She is seen in the office for an office visit, 99204, and has blood drawn for a lab test, 36415. 1. For this patient, determine: (1) What amount Medicare pays the physician. (2) What amount the Medigap/supplemental plan pays. (3) What amount the patient pays. FORSSOVEVADZE (4) What amount is written off. Part B Students may wish to refer to the chapters on the introduction to the revenue cycle and patient encounter and billing information in this workbook for a review of math for the following problems. Dr. Augustino is a Medicare participating provider. Dr. Brunner is a Medicare nonparticipating provider who accepts assignment. Dr. Charles is a Medicare nonparticipating provider who does not accept assignment. The following table shows the fees each doctor charges as well as the Medicare Fee. Medico Partica 99201 OV New 99204 OV New 99212 OV Est 99213 OV Est 71046 Chest X-ray 36415 Venipuncture Dr. A 45.00 60.00 40.00 45.00 165.00 17.00 Dr. B 42.50 57.50 38.00 40.00 162.50 12.00 Dr. C 48.00 65.00 45.00 48.00 174.00 20.00 Medicare 36.00 48.25 32.00 35.75 73.25 8.00 Medigap Plans Effective January 1, 2017 A B C D F G K L M N Medigap Benefits Medicare Part A Coinsurance hospital costs up to an additional 365 days after Medicare benefits are used up Medicare Part B Coinsurance or Copayment 75% Blood (First 3 pints) 75% Part A Hospice Care Coinsurance or Copayment 75% Skilled Nursing Facility Care Coinsurance VVVVV 50% VVVVV 50% VV V V V 50% 50% VVVVV 50% V VVV 75% Medicare Part A Deductible 75% 50% Medicare Part B Deductible Medicare Part B Excess Charges Foreign Travel Emergency (Up to Plan Limits) Medicare Preventive Care Part B Coinsurance Outlet $5,120 $2,560 FIGURE 9.7 Medigap Coverage. Plans (2017) . Audrey Appel, who is covered by Medicare as well as a Medigap policy, is a new patient of Dr. Augustino. She is seen in the office for an office visit, 99204, and has blood drawn for a lab test, 36415. 1. For this patient, determine: (1) What amount Medicare pays the physician. (2) What amount the Medigap/supplemental plan pays. (3) What amount the patient pays. FORSSOVEVADZE (4) What amount is written off. Part B Students may wish to refer to the chapters on the introduction to the revenue cycle and patient encounter and billing information in this workbook for a review of math for the following problems. Dr. Augustino is a Medicare participating provider. Dr. Brunner is a Medicare nonparticipating provider who accepts assignment. Dr. Charles is a Medicare nonparticipating provider who does not accept assignment. The following table shows the fees each doctor charges as well as the Medicare Fee. Medico Partica 99201 OV New 99204 OV New 99212 OV Est 99213 OV Est 71046 Chest X-ray 36415 Venipuncture Dr. A 45.00 60.00 40.00 45.00 165.00 17.00 Dr. B 42.50 57.50 38.00 40.00 162.50 12.00 Dr. C 48.00 65.00 45.00 48.00 174.00 20.00 Medicare 36.00 48.25 32.00 35.75 73.25 8.00 Medigap Plans Effective January 1, 2017 A B C D F G K L M N Medigap Benefits Medicare Part A Coinsurance hospital costs up to an additional 365 days after Medicare benefits are used up Medicare Part B Coinsurance or Copayment 75% Blood (First 3 pints) 75% Part A Hospice Care Coinsurance or Copayment 75% Skilled Nursing Facility Care Coinsurance VVVVV 50% VVVVV 50% VV V V V 50% 50% VVVVV 50% V VVV 75% Medicare Part A Deductible 75% 50% Medicare Part B Deductible Medicare Part B Excess Charges Foreign Travel Emergency (Up to Plan Limits) Medicare Preventive Care Part B Coinsurance Outlet $5,120 $2,560 FIGURE 9.7 Medigap Coverage. Plans (2017)
