can someone help me with this
Problem #9 and #13 (Combined) - WEEK 7- PRACTICAL EXERCISE combined) - The Statistics Budget and Calculating RVUS. In Table 1.la on page 499, the encounters are lucrative contract and their visits will increase to recalculate the encounters. counters are calculated with the expectation that the company is getting a its will increase by 5%. For Problem 9, the situation has changed and you need You must calculate the number of Admis will be from commercial payors. year. In addition, in Problem #13 the RVUs have changed. te the number of Admission visits and follow-up visits for 20X2 that commercial payors. We are only doing the first quarter - not the whole You must calculate the total number of RVUs that will now be generated by the nd Follow-up Commercial visits. Givens from Problem 9: ZMG Hospitalist Practice will NOT get an HMO Contract. Monthly encounters are expected to rise by 1.5% (0.015) from the previous year. Givens from Problem 13: Relative Value Weight for Admissions is 3.50. . Relative Value Weight for Follow-ups is 1.75. Steps involved in creating a statistics budget: Develop an overall volume projection. This is done by multiplying the previous years numbers by the projected change in volume, then adding this to the previous years volume. Categorize volume projection by payor and encounter type. In Exhibit I. lb on page 500 you are told what percentage of the overall visits for the company come from Commercial, Medicare, and Medicaid/Self-Pay. According to that information, Commercial Admission visits are equal to 9% 0.09) of the total, and Commercial Follow-up Visits are 27% (0.27) of the total. Convert encounters to weighted encounters. This process is explained on page 500 in your text. In Problem #13 you are given the Relative Value Weights (RVUS) for both Admission and Follow-up visits. USING THE INFORMATION ABOVE, AND THE FORMULAS GIVEN IN THIS TABLE, MAKE THE INDICATED CALCULATIONS. FORMULAS FEB MAR TOTAL A TOTAL 20XI ENCOUNTERS 5007 4676 5014 14727 B. PROJECTED PERCENT OF GROWTH 0.015 0.015 0,015 0.015 C. TOTAL 20X2 ENCOUNTERS A +(AXB) D. PERCENT OF ADMISSION VISITS FROM COMMERCIAL PAYORS .09 .09 E NUMBER OF COMMERCIAL ADMISSION VISITS DXC F. RVUS PER COMMERCIAL ADMISSION VISIT 3.50 G. TOTAL RVUS FOR COMMERCIAL ADMISSION VISITS FxE H. PERCENT OF FOLLOW-UP VISITS FROM COMMERCIAL PAYORS I NUMBER OF COMMERCIAL FOLLOW-UP HxC VISITS J. RVUS PER COMMERCIAL FOLLOW-UP 1.75 VISIT K. TOTAL RVUS FOR COMMERCIAL Jx! FOLLOW-UP VISITS 1.75 Problem #18 - The Revenue Budget and Exhibit I1.e. This problem looks at calculating the gross and net patient revenues from Medicare encounters. Givens: Charge for a Weighted Medicare Admission Visit is $200.00. Charge for a Weighted Medicare Follow-Up Visit is $100.00. Medicare Discounts payments by 40% (-40). USING THE INFORMATION ABOVE, AND THE FORMULAS GIVEN IN THIS TABLE, MAKE THE INDICATED CALCULATIONS. FORMULAS JAN FEB MAR | TOTAL A. MEDICARE WEIGHTED ADMISSION VISIT 2964 B. PRICE OF WEIGHTED MEDICARE $200.00 $200.00 ADMISSION VISIT $200.00 $200.00 C. GROSS REVENUE FROM MEDICARE ADMISSION VISIT AXB D. DISCOUNT RATE E. SSS AMOUNT OF DISCOUNT FOR DXC ADMISSION VISITS F. NET REVENUE FROM MEDICARE ADMISSION VISITS C minus E G. MEDICARE WEIGHTED FOLLOW-UP VISITS 4416 4448 12988 H. PRICE OF WEIGHTED MEDICARE $100.00 FOLLOW-UP VISIT $100.00 $100.00 $100.00 L GROSS REVENUE FROM MEDICARE FOLLOW-UP VISIT GxH J. DISCOUNT RATE 40 40 K. SSS AMOUNT OF DISCOUNT FOR FOLLOW UP VISIT JUI L NET REVENUE FROM MEDICARE Iminus K FOLLOW-UP VISIT
