Answered step by step
Verified Expert Solution
Link Copied!

Question

1 Approved Answer

Q - ( 1 ) . Using context clues, fill in the blanks in the below paragraph using the below list of terms. There are

Q-(1). Using context clues, fill in the blanks in the below paragraph using the below list of terms. There are more terms than there are blanks and the same term can be used multiple times.
1. Allowed amount
2. Coinsurance
3. Copayment
4. Contractual adjustment
5. Deductible
6. Premium
In August 2020, Josephine needs surgery to alleviate her sciatica. Her plan has some substantial cost-sharing and therefore she wants to do her homework and shop around for cost efficient surgeon. She has a $5,000 annual (a)__________ for medical expenses, and once she meets that, she has 15%(b)__________. She was sick in January with flu and saw the doctor a few times and therefore spent about $400 towards her annual (c)__________. She has contacted 2 hospitals and found out that Hospital A charges $10,000 for the procedure and Hospital B charges $12,000 for the procedure. She has called her insurance company (she purchases insurance through her employer) and found out that they have negotiated a (d)__________ so that the total e)__________for Hospital A is $9,000 and the total (f)__________for Hospital B is $8,000.
Q-(2). If Jo wants to minimize costs, which hospital should she choose?
a. Hospital A
b. Hospital B
c. Either costs are the same for the both
Q-(3). What is Jo's total out-of-pocket expenditure?
a) $8,000
b) $1,200
c) $5,110
d) $11,400
Q-(4). Jo is in charge of benefits at her company and knows that next year, her plan will change so that she will have a lower deductible ($4,000) and the coinsurance will stay the same. If Jo waits until Jan 1,2021, what will her total out-of-pocket expenditure be for the surgery? Assume the negotiated discounts between payers and Hospital A and B don't change.
Q-(5). Jo tells her doctor of her plans to wait and the doctor prescribes her medication to manage the pain for the next 4 months. The medications costs $150 for a 30-day supply. It is not on the formulary and therefore she has $50 copay each month. Incorporating the out-of-pocket cost of the medication, when should she have the surgery?

Step by Step Solution

There are 3 Steps involved in it

Step: 1

blur-text-image

Get Instant Access to Expert-Tailored Solutions

See step-by-step solutions with expert insights and AI powered tools for academic success

Step: 2

blur-text-image

Step: 3

blur-text-image

Ace Your Homework with AI

Get the answers you need in no time with our AI-driven, step-by-step assistance

Get Started

Recommended Textbook for

Working Capital Management And Finance A HandBook For Bankers And Finance Managers

Authors: R.K.Gupta, Himanshu Gupta

4th Edition

1645875547, 9781645875543

More Books

Students also viewed these Finance questions