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S Case 1.2 Calculating Insurance Math Note: this question will not be automatically graded. It will be sent to your instructor for review. Calculate the payment(s) billed in each of the following situations. A. The patient's health plan has a $100 annual deductible. At the first visit of the year, the charges are $95. What does the patient owe? $ B. The patient's coinsurance percentage is stated as 75-25 in the insurance policy. The deductible for the year has been met. If the visit charges are $1,000, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ C. The patient's coinsurance percentage is stated as 80-20 in the insurance policy. The deductible for the year has been met. If the visit charges are $420, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ D. The patient is enrolled in a capitated HMO with a $10 copayment for primary care physician visits and no coinsurance requirements. After collecting $10 from the patient, what amount can the medical insurance specialist bill the payer for an office visit? E. The patient has a policy that requires a $20 copayment for an in-network visit due at the time of service. The policy also requires 30 percent coinsurance from the patient. Today's visit charges total $785. After subtracting the copayment collected from the patient, the medical insurance specialist expects a payment of what amount from the payer? What amount will the patient be billed? $ $ F. A patient's total surgery charges are $1,278. The patient must pay the annual deductible of $1,000, and the policy states a 80- 20 coinsurance. What does the patient owe? $ G. 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 procedure costing $1,890, what does the patient owe? Can any amount be collected from a payer? Why?

S Case 1.2 Calculating Insurance Math Note: this question will not be automatically graded. It will be sent to your instructor for review. Calculate the payment(s) billed in each of the following situations. A. The patient's health plan has a $100 annual deductible. At the first visit of the year, the charges are $95. What does the patient owe? $ B. The patient's coinsurance percentage is stated as 75-25 in the insurance policy. The deductible for the year has been met. If the visit charges are $1,000, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ C. The patient's coinsurance percentage is stated as 80-20 in the insurance policy. The deductible for the year has been met. If the visit charges are $420, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ D. The patient is enrolled in a capitated HMO with a $10 copayment for primary care physician visits and no coinsurance requirements. After collecting $10 from the patient, what amount can the medical insurance specialist bill the payer for an office visit? E. The patient has a policy that requires a $20 copayment for an in-network visit due at the time of service. The policy also requires 30 percent coinsurance from the patient. Today's visit charges total $785. After subtracting the copayment collected from the patient, the medical insurance specialist expects a payment of what amount from the payer? What amount will the patient be billed? $ $ F. A patient's total surgery charges are $1,278. The patient must pay the annual deductible of $1,000, and the policy states a 80- 20 coinsurance. What does the patient owe? $ G. 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 procedure costing $1,890, what does the patient owe? Can any amount be collected from a payer? Why?

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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S Case 1.2 Calculating Insurance Math Note: this question will not be automatically graded. It will be sent to your instructor for review. Calculate the payment(s) billed in each of the following situations. A. The patient's health plan has a $100 annual deductible. At the first visit of the year, the charges are $95. What does the patient owe? $ B. The patient's coinsurance percentage is stated as 75-25 in the insurance policy. The deductible for the year has been met. If the visit charges are $1,000, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ C. The patient's coinsurance percentage is stated as 80-20 in the insurance policy. The deductible for the year has been met. If the visit charges are $420, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ D. The patient is enrolled in a capitated HMO with a $10 copayment for primary care physician visits and no coinsurance requirements. After collecting $10 from the patient, what amount can the medical insurance specialist bill the payer for an office visit? E. The patient has a policy that requires a $20 copayment for an in-network visit due at the time of service. The policy also requires 30 percent coinsurance from the patient. Today's visit charges total $785. After subtracting the copayment collected from the patient, the medical insurance specialist expects a payment of what amount from the payer? What amount will the patient be billed? $ $ F. A patient's total surgery charges are $1,278. The patient must pay the annual deductible of $1,000, and the policy states a 80- 20 coinsurance. What does the patient owe? $ G. 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 procedure costing $1,890, what does the patient owe? Can any amount be collected from a payer? Why?
Transcribed Image Text:S Case 1.2 Calculating Insurance Math Note: this question will not be automatically graded. It will be sent to your instructor for review. Calculate the payment(s) billed in each of the following situations. A. The patient's health plan has a $100 annual deductible. At the first visit of the year, the charges are $95. What does the patient owe? $ B. The patient's coinsurance percentage is stated as 75-25 in the insurance policy. The deductible for the year has been met. If the visit charges are $1,000, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ C. The patient's coinsurance percentage is stated as 80-20 in the insurance policy. The deductible for the year has been met. If the visit charges are $420, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed? $ $ D. The patient is enrolled in a capitated HMO with a $10 copayment for primary care physician visits and no coinsurance requirements. After collecting $10 from the patient, what amount can the medical insurance specialist bill the payer for an office visit? E. The patient has a policy that requires a $20 copayment for an in-network visit due at the time of service. The policy also requires 30 percent coinsurance from the patient. Today's visit charges total $785. After subtracting the copayment collected from the patient, the medical insurance specialist expects a payment of what amount from the payer? What amount will the patient be billed? $ $ F. A patient's total surgery charges are $1,278. The patient must pay the annual deductible of $1,000, and the policy states a 80- 20 coinsurance. What does the patient owe? $ G. 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 procedure costing $1,890, what does the patient owe? Can any amount be collected from a payer? Why?
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