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Case 13.2 Calculating Insurance Math Patient Payment Claim Adjustment Patient Date of Provider Allowed (Coinsurance and Reason PROV Patient ID Name Plan Service Procedure

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Case 13.2 Calculating Insurance Math Patient Payment Claim Adjustment Patient Date of Provider Allowed (Coinsurance and Reason PROV Patient ID Name Plan Service Procedure Charge Amount Deductible) Code PAY BBG-88-5267 Ramirez, R-1 Gloria B. 02/13/2029- 99214 02/13/2029 $105.60 $59.00 $8.85 2 $50.15 348-99-2537 Finucula, R-1 Betty R. 01/15/2029- 99292 01/15/2029 $88.00 $50.00 $7.50 2 $42.50 537-12B-5267 Ramirez, 760-57-5372 Jugal, R-1 Gloria B. 02/14/2029- 02/14/2029 90732 $38.00 0 $38.00 49 0 R-1 Kurt T. 121ZZul Quan, Mary K. PPO-3 02/16/2029- 20005 02/16/2029 02/16/2029- 93975 $580.00 $261.00 02/16/2029 99204 $178.00 $103.00 $192.00 $156.00 $139.15 12 $121.85 $15.45 $87.55 $31.20 2 $124.80 The preceding RA has been received by a provider. A. What is the patient coinsurance percentage required under plan R-1? B. What is the patient coinsurance percentage required under plan PPO-3? C. What is Gloria Ramirez's balance due for the two dates of service listed? TOTAL $426.85 < Prev 1 of 1

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