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Your facility has the following payer mix: 40% commercial insurances 25% Medicare insurance 15% Medicaid insurance 15% liability insurance 5% all others including self-pay The

Your facility has the following payer mix:

40% commercial insurances

25% Medicare insurance

15% Medicaid insurance

15% liability insurance

5% all others including self-pay

The average Medicare rate for each case is $6200- use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare, Liability insurers average 200% of Medicare and the others average 100% of Medicare rates. (What are the individual reimbursement rates for all 5 payers?)

  1. What are the expected rates of reimbursement for this time frame for each payer? What is your expected A/R?

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