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. Dr. Augustino is a Medicare participating provider. Dr. Brunner is a Medicare nonparticipating provider who accepts assignment. Dr. Charles is a Medicare nonparticipating provider who does not accept the assignment. The following table shows the fees each doctor charges as well as the Medicare Fee. Dr. A Dr. B Dr. C Medicare 99201 OV New 45.00 42.50 48.00 36.00 99204 OV New 60.00 57.50 65.00 48.25 99212 OV Established 40.00 38.00 45.00 32.00 99213 OV Established 45.00 40.00 48.00 35.75 71046 Chest X-ray 165.00 162.50 174,00 73.25 36415 Venipuncture 17.00 12.00 20.00 8.00 Audrey Appel who is covered by Medicare, as well as a Medigap policy, is a new patient of Dr. Augustino. She is seen in the office for an office! visit 99204 and has blood drawn for a lab test 36415. For this patient determine: 1 What amount Medicare pays the physician. 2 What amount the Medigap/supplemental plan pays. 3 What amount the patient pays. 4 What amounts is written off.
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.
Dr. Augustino is a Medicare participating provider. Dr. Brunner is a Medicare nonparticipating provider who accepts assignment. Dr. Charles is a Medicare nonparticipating provider who does not accept the assignment. The following table shows the fees each doctor charges as well as the Medicare Fee.
|
|
Dr. A |
Dr. B |
Dr. C |
Medicare |
|
99201 OV New |
45.00 |
42.50 |
48.00 |
36.00 |
|
99204 OV New |
60.00 |
57.50 |
65.00 |
48.25 |
|
99212 OV Established |
40.00 |
38.00 |
45.00 |
32.00 |
|
99213 OV Established |
45.00 |
40.00 |
48.00 |
35.75 |
|
71046 Chest X-ray |
165.00 |
162.50 |
174,00 |
73.25 |
|
36415 Venipuncture |
17.00 |
12.00 |
20.00 |
8.00 |
Audrey Appel who is covered by Medicare, as well as a Medigap policy, is a new patient of Dr. Augustino. She is seen in the office for an office! visit 99204 and has blood drawn for a lab test 36415.
- For this patient determine:
1 What amount Medicare pays the physician.
2 What amount the Medigap/supplemental plan pays.
3 What amount the patient pays.
4 What amounts is written off.
Benny Brown who is covered by Medicare as well as a Medigap policy is an established patient of Dr. Brunner. He comes to the office complaining of difficulty breathing. After a problem-focused examination and medical history 99213 he also receives a chest X-ray 71046.
- For this patient determine:
1 What amount Medicare pays the physician.
2 What amount the Medigap/supplemental plan pays.
3 What amount the patient pays.
4 What amounts is written off.
Cathy Craine, who is covered by Medicare but does not have a Medigap policy, is a new patient of Dr. Charles. She is seen for a minor cold, 99201
- For this patient determine:
1 What amount Medicare pays the physician.
2 What amount the Medigap/supplemental plan pays.
3 What amount the patient pays.
4 What amounts is written off.
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