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Under the provider's ratio of cost to charges, for a claim of $2,400 and a provider RCC of 40%, the payment for that claim would
Under the provider's ratio of cost to charges, for a claim of $2,400 and a provider RCC of 40%, the payment for that claim would be: a) $2,400 b) $960 Oc) $3,360 d) $400 A DRG plan stipulated that for all claims in excess of $70,000 in billed charges, the payor will not pay the claim on a DRG basis, but at 75% of billed charges. If the claim had a DRG payment of $18,000 and the patient incurred $82,000 of total charges, the payor would pay a) $1,000 b) $82,000 c) $61,500 d) $100,000 If a health plan agrees to pay the provider at 70% of its billed charges to cover its costs, the provider would need to charge ____ for a patient's claim for $100? a) $142.85 b) $100.00 c) $70.00 d) $152.97 O e) $136.54
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