Case Study 16.9

Patient: Joseph Zylerberg

The following information is taken from two RAs. The first RA is from Medicare Nationwide, the primary payer. Note that the patient has met the deductible for the primary payer. The second RA is from Medicaid, the secondary carrier. The patients Medicaid copay for the secondary plan has not yet been paid.

PRIMARY CARRIER

POS PROC BILLED ALLOWED DEDUCT COINS/COPAY PROV PD

11 99204 150.00 103.00 0.00 20.60 82.40

11 93000 70.00 29.00 0.00 5.80 23.20

SECONDARY CARRIER

POS PROC BILLED ALLOWED DEDUCT COINS/COPAY PROV PD

11 99204 150.00 103.00 0.00 15.00 5.60

11 93000 70.00 29.00 0.00 0.00 5.80

Patient balance: $