Question
I have a scenario that I need help understanding how to calculate finding. A patient saw her OB dr for a well-woman exam. Total charges
I have a scenario that I need help understanding how to calculate finding.
A patient saw her OB dr for a well-woman exam. Total charges are $185. Patient has 2 insurances.
Primary insurance BCBS, copay $25, 100% beneift after copay, allowed amount $150.
Secondary insurance Cigna, deductible $200 (already met), 80% benefit after deductible, allowed amount $125.
Money collected from patient was 0.00
How much money did Dr receive?
How much should BCBS have paid?
How much should Cigna have paid?
How much is the claim overpaid? Who overpaid on the claim?
If you could show how you got the amounts, would be appreciated. I'm having trouble understanding how to figure out the 2 insurance claims.
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