Revenue Level 2 - Payer volumes shown are per month Managed Care #1 (Blue Cross) same as Level 1. Look at the first question in the assignment and bring those same figures for Managed Care #1 above into the Managed Care #1 boxes for this question Format with dollars and cents. Use commas for items over 1,000,00. Do not use dollar signs. For example: 35,200,00 1.27954 235.80 Note that this scenario is different from the first question. MRI scan of leg before and after contrast has a code of 73720 with a full service rate of 5325.00 In this scenario, ther are more Medicare patients in the mix. There are more overall patients as well as a higher full service rate for the MRI leg scan. This all leads to a higher revenue amount in this question compared to question #1 in this assignment. Payer Payment Rate Number of Patients Revenue Volumes Medicare $150.00 450 Medicaid $140.00 100 Managed Care #1 (Blue Cross) Managed Care #2 (Aetna) Uninsured 80% of charges at rate of 125 $160.00 15% of charges at rate of 150 $325.00 (nothing in this box) Total patients & Revenue The US health care systemuses multiple payers. As you calculate these revenue answers, review the impact that different payer mixes have on the income. Revenue Level 1 - Payer volumes shown are per month Format with dollars and cents. Use cornmas for items over 1,000.00. Do not use dollar signs. For example: 35,200.00 1,279.54 235.80 For this Level 1 example, MRI scan of leg has a code of 73718 with a full service rate of $225.00 The revenue is determined by multiplying the payment rate by the number of patients. *Math review - for the Aetna example below. First, calculate the payment rate. Convert 80% to 8 and multiply by $120. Once you have this payment rate figure, multiply it by the 125 number of patients. Follow these same steps to calculate the uninsured payment rate. Payer Volumes Payment Rate Number of Patients Revenue Medicare $100.00 370 37,000.00 Medicaid $90.00 120 10,800.00 29,450.00 12,000.00 Managed Care $95.00 310 #1 (Blue Cross for example) Managed Care 80% of charges 125 #2 (Aetna for at rate of example) $120.00* Uninsured 15% of charges 150 at rate of $225.00 Total patients & (nothing in this 1,075 Revenue box) 5,062.50 94,312.50 Revenue Level 2 - Payer volumes shown are per month Managed Care #1 (Blue Cross) same as Level 1. Look at the first question in the assignment and bring those same figures for Managed Care #1 above into the Managed Care #1 boxes for this question Format with dollars and cents. Use commas for items over 1,000,00. Do not use dollar signs. For example: 35,200,00 1.27954 235.80 Note that this scenario is different from the first question. MRI scan of leg before and after contrast has a code of 73720 with a full service rate of 5325.00 In this scenario, ther are more Medicare patients in the mix. There are more overall patients as well as a higher full service rate for the MRI leg scan. This all leads to a higher revenue amount in this question compared to question #1 in this assignment. Payer Payment Rate Number of Patients Revenue Volumes Medicare $150.00 450 Medicaid $140.00 100 Managed Care #1 (Blue Cross) Managed Care #2 (Aetna) Uninsured 80% of charges at rate of 125 $160.00 15% of charges at rate of 150 $325.00 (nothing in this box) Total patients & Revenue The US health care systemuses multiple payers. As you calculate these revenue answers, review the impact that different payer mixes have on the income. Revenue Level 1 - Payer volumes shown are per month Format with dollars and cents. Use cornmas for items over 1,000.00. Do not use dollar signs. For example: 35,200.00 1,279.54 235.80 For this Level 1 example, MRI scan of leg has a code of 73718 with a full service rate of $225.00 The revenue is determined by multiplying the payment rate by the number of patients. *Math review - for the Aetna example below. First, calculate the payment rate. Convert 80% to 8 and multiply by $120. Once you have this payment rate figure, multiply it by the 125 number of patients. Follow these same steps to calculate the uninsured payment rate. Payer Volumes Payment Rate Number of Patients Revenue Medicare $100.00 370 37,000.00 Medicaid $90.00 120 10,800.00 29,450.00 12,000.00 Managed Care $95.00 310 #1 (Blue Cross for example) Managed Care 80% of charges 125 #2 (Aetna for at rate of example) $120.00* Uninsured 15% of charges 150 at rate of $225.00 Total patients & (nothing in this 1,075 Revenue box) 5,062.50 94,312.50
