Physician Office Revenue for Visit Code 99214 has a full established rate of $72
ID: 248107 • Letter: P
Question
Physician Office Revenue for Visit Code 99214 has a full established rate of $72.00. Of ten different payers, there are nine different contracted rates, as follows:
Payer Contracted Rate
FHP $35.70
HPHP 58.85
MC 54.90
UND 60.40
CCN 70.20
MO 70.75
CGN 10.00
PRU 54.90
PHCS 50.00
ANA 45.00
Rates for illustration only.
Required
1. Set up a worksheet with four columns: Payer, Full Rate, Contracted Rate, and Contractual Allowance.
2. For each payer, enter the full rate and the contracted rate.
3. For each payer, compute the contractual allowance.
The first payer has been computed below:
Full Contracted Contractual
Payer Rate (less) Rate = Allowance
FHP $72.00 $35.70 $36.30
Explanation / Answer
For each payer, compute the contractual allowance.
Payer Full Rate Contracted Rate Contractual Allowance
FHP $72.00 $35.70 $36.30
HPHP 72.00 58.85 13.15
MC 72.00 54.90 17.10
UND 72.00 60.40 11.60
CCN 72.00 70.20 1.80
MO 72.00 70.75 1.25
CGN 72.00 10.00 62.00
PRU 72.00 54.90 17.10
PHCS 72.00 50.00 22.00
ANA 72.00 45.00 27.00