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Students may wish to refer to the chapters on the introduction to the revenue cycle and patient encounter and billing information in this workbook

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Students may wish to refer to the chapters on the introduction to the revenue cycle and patient encounter and billing information in this workbook for a review of math for the following problems. 1. Pete Weiskner is a retired Air Force captain; he is covered by TRICARE Select A. He recently had an annual colonoscopy as he has a family history of colon cancer. The procedure was performed by a nonparticipating provider. The total allowed charge was $832; the provider billed Pete $956.80. Pete has met his annual deductible. (1) What amount will Pete be responsible for? (2) What amount will be reimbursed by TRICARE? 2. Eva Logorda's husband, Angelo, is completely disabled due to a service- related injury. When Eva comes to your office, you verify her eligibility through her A-card. She notes that she has a $100 deductible and has met $49 of the deductible for this year. Today she receives a complete physical exam; the charges total $276. (1) What amount will Eva be responsible for? (2) What amount will be reimbursed by CHAMPVA? 3. Leon Rosen recently retired from the Navy. He and his wife, Miriam, must choose a TRICARE health plan. They have decided to use a typical office visit with total charges of $45 as an example to help determine the best plan for them. Assume they have met any deductible, premiums, or other fees to enroll in the program. (1) What is the out-of-pocket amount for the office visit under TRICARE Select? (2) What is the out-of-pocket amount for the office visit under TRICARE Prime?

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