where are the answers to this on chegg. how is it labeled? it's insurance in the medical office from patient to payment 7th edition

Participating Provider Payment Method Discounted Fee-for Service Per Member Per Month under Health Plans on (HM tated consumer-Driven Health Up to deductible: Payment by Patient uctible: Discounted Fee-for-Service ich as S5,000 to $10,000, in met. Some plans an order to offer managed care teat costs ig ive premium. Many have some d try to control Provider Payments Medical assistants become familiar with the payment approaches of the health plans patients have, so they can calculate charges due at time of service, anticipate pay ments after claims are processed, and explain insurance payment calculations to pa tients who need to know their own financial responsibilities. Table 6.3 reviews physician payments under the major types of managed care and indemnity plans THINKING IT THROUGH 6.1 1. A patient's total surgery charges are $1,278. The patient must pay the annual deductible of $1,000, and the policy states an 80-20 coinsurance What does the patient owe? 2. A patient has a high-deductible consumer-driven health plan. The annual deductible is $2,500, of which $300 has been paid. After a surgical pro- cedure costing $1,890, what does the patient owe? Can any amount be collected from a payer? Why? atient with a high-deductible consumer-driven health plan has met half of the $1,000 annual deductible before requiring surgery to repair a broken ankle while visiting a neighboring state. The out-of-network physician's billis $4,500. The PPO that takes effect after the deduct- ible has been met is an 80-20 in-network plan and a 60-40 out-of- network plan. How much does the patient owe? How much should the PPO be billed? 6.2 Methods for Setting Fees Physicians establish a list of their usual fees for the procedures and services thev frequently perform. Usual fees are defined as those that they charge to most of their patients most of the time under typical conditions. These fees are compiled in the physician's fee schedule Payers, too, must establish the rates they pay providers. There are tw hods charge-based and resource-based. Charge-based fee structures are based on fee Chapter 6 PAYMENT METHODS AND CHEC