John is seen as a new patient in a cardiologists office. He has met $75.00 of his $250.00 deductible for the year. His coinsurance amount is 20%. The cardiologist is a PAR provider with his insurance.

Charges:

CPT Codes	Charge	Allowed Amount
99203	$225.00	$205.00
93000	$188.00	$167.00
71020	$105.00	$95.00

1. How much will the insurance company pay?

2. What will the patient owe?

atient is seen by an Orthopedic surgeon and scheduled to undergo a right total knee replacement. the patient has met $330.00 of their yearly $500.00 deductible. The patient has a 20% coinsurance on their Premera policy.

Calculate the patient and insurance payment amounts:

CPT Code	Charge	Insurance Allowed Amount
99203	$250.00	$205.00
27447-RT	$3,825.00	$3,545.00

What will the insurance pay on the above charges?

What will the patient owe if they see a PAR provider?

What will the patient owe if they see a nonPAR provider