Calculate the financial responsibility of the patient, the amount the carrier will pay, and the amount the provider must write off. 1. Annie Bates was seen in the doctors office today for sinusitis. She is subject to her annual deductible of $150.00. Once her deductible is met, she must pay a copayment of $20.00. Todays total billed charges are $215.00. The allowed amount is $175.00. Usual charge ______________________

Allowed charge ______________________

Deductible______________________

Policy pays _____________ of the allowed charge, which is ______________.

Patient is responsible for the _________ of the allowed charge, which is _______.

Provider writes off the difference between the usual and allowed charge: ________________.

________________ Patients responsibility

________________ Write-off

________________ Carrier pays