QUESTIONS 1-6 Students may wish to refer to the chapters on the introduction to
ID: 3143782 • Letter: Q
Question
QUESTIONS 1-6
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. Joseph D'Amico is covered by BlueCross and Medicare. His BlueCross plan has an 85-15 coinsurance and a $100 deductible. This year's Medicare deductible is $110. He was seen in our office on January 11: charges for the office visit were $135. Claims were submitted to BlueCross as primary payer and to Medicare as secondary payer. 1. What amount will BlueCross be responsible for? 2. What amount will Medicare be responsible for? 3. What amount will Mr. D'Amico be responsible for? Mr. D'Amico saw the doctor again in February. Charges for the office visit and tests were $215. 4. What amount will BlueCross be responsible for? 5. What amount will Medicare be responsible for? 6. What amount will Mr. D'Amico be responsible for? The RA on page 176 was received by your practice on FebruaExplanation / Answer
1 ans) Blue cross pays 85% of 135 = $114.75
2 ans) medicares pays 110% of 135 = $148.5
3 ans)Dr amico responsible for both so answer is 114.75+148.5=$263.25
4 ans) Blue cross pays 85% of 215=$182.75
5 ans) medicares pays 110% of 215=$236.5
6 ans) Dr amicos is responsible for both so 182.75+236.5=$419.25