Question
For this activity, the physician is a participating provider (PAR), which means the provider has contracted with the third-party payer and will provide a discount
For this activity, the physician is a participating provider (PAR), which means the provider has contracted with the third-party payer and will provide a discount to the patient. Calculate the amounts paid by the payer and the patient and the amount the provider must write off.
1. The patient is seen by his family physician for follow-up treatment of recently diagnosed asthmatic bronchitis. The physicians fee is $75. The patients copayment is $20, and the patient is not required to pay any additional amount to the provider. The payer reimburses the physician $28.
Enter the amount the patient pays the provider: ____________
Enter the amount the payer reimburses the provider: ____________
Enter the amount the provider writes offthe account: ____________
2. The patient undergoes chemical ablation of one facial lesion in her physicians office. The physicians fee is $240. The patients copayment is $18, and the patient is not required to pay any additional amount to the provider. The payer reimburses the physician $105.
Enter the amount the patient pays the provider: ____________
Enter the amount the payer reimburses the provider: ____________
Enter the amount the provider writes offthe account: ____________
3. The patient undergoes arthroscopic surgery at an ambulatory surgical center. The surgeons fee is $890. The patients coinsurance is 20 percent of the $700 fee schedule, and the patient is not required to pay any additional amount to the provider. The payer reimburses the surgeon 80 percent of the $700 fee schedule.
Enter the amount the patient pays the provider: ____________
Enter the amount the payer reimburses the provider: ____________
Enter the amount the provider writes offthe account: ____________
4. The patient was referred to an orthopedic specialist for evaluation of chronic ankle pain. The physicians fee is $150. The patients coinsurance is 30 percent of the $100 fee schedule, and the patient is not required to pay any additional amount to the provider. The payer reimburses the physician 70 percent of the $100 fee schedule for this service.
Enter the amount the patient pays the provider: ____________
Enter the amount the payer reimburses the provider: ____________
Enter the amount the provider writes offthe account: ____________
5. The patient received preventive medicine services. The physicians fee is $150. The patients copayment is $10 of the $75 fee schedule, and the patient is not required to pay any additional amount to the provider. The payer reimburses the physician 80 percent of the $75 fee schedule.
Enter the amount the patient pays the provider: ____________
Enter the amount the payer reimburses the provider: ____________
Enter the amount the provider writes offthe account: ____________
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