what You have been hired as the billing manager for Nash Medical Center and Clinics One...

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what You have been hired as the billing manager for Nash Medical Center and Clinics One of your responsibilities to calculate what the patient owes and what the insurance company owes, so that you can determine revenue to expect for these services You have the charge and the usual, customary, and reasonable (UCR) amount The reimbursement will be calculated on the 80/20 distribution The deductibles for each of these patients have been met. Under this insurance plan, $20.00 copays are due for primary care physician visits and $40.00 copays for specialists There is no copay for other services. The Medical Center also recently negotiated with a group of employers capitated amount of $750 per person per month This group of employers predict that your cost will be $610 per month per person. The budgeted revenue was initially $1,575,000. You were provided with the following report. office to treat their patients based on a has combined 6,525 employees . You is Service Charge UCR Patient's Copay Patient's Insurance Patient Coinsurance Pays Owe Internal medicine $120.00 $120.00 $20 $24 $96 $44 Physical therapy $150.00 $97.00 $0 $19.40 $77.60 $19.40 X-ray $115.00 $73.00 $0 $14.60 $58.40 $14.60 MRI $1,845.00 $147.00 $0 $29.40 $117.60 $29.40 Specialty visit $165.00 $90.00 $40 $18 $72 $58 Specialty visit $75.00 $70.00 $40 $14 $56 $54 Lab test $32.00 $19.00 $0 $3.80 $15.20 $3.80 Lab test $45.00 $29.00 $0 $5.80 $23.20 $5.80 Mammogram $151.00 $95.00 $0 $19 $76 $19 Using the reimbursement information calculate: Coinsurance Copay amount, if any Amount insurance will pay How much the patient owes Based on the negotiated capitation amount, predict: Total amount of revenue per month $4,893,750 Total amount of revenue per year - $58,725,000 . Total profit expected per month - $913,500 Total profit expected per year - $10,962,000 An executive summary is a document or proposal that provides a brief overview or summary In this case, it is used to summarize the findings of your report. In a 1-page executive summary : . Summarize your reimbursement data. Determine what revenue to expect for each of the services the services. Summarize your prediction and forecasting data. Compare to the budgeted revenue. Explain potential reasons for budget variances what You have been hired as the billing manager for Nash Medical Center and Clinics One of your responsibilities to calculate what the patient owes and what the insurance company owes, so that you can determine revenue to expect for these services You have the charge and the usual, customary, and reasonable (UCR) amount The reimbursement will be calculated on the 80/20 distribution The deductibles for each of these patients have been met. Under this insurance plan, $20.00 copays are due for primary care physician visits and $40.00 copays for specialists There is no copay for other services. The Medical Center also recently negotiated with a group of employers capitated amount of $750 per person per month This group of employers predict that your cost will be $610 per month per person. The budgeted revenue was initially $1,575,000. You were provided with the following report. office to treat their patients based on a has combined 6,525 employees . You is Service Charge UCR Patient's Copay Patient's Insurance Patient Coinsurance Pays Owe Internal medicine $120.00 $120.00 $20 $24 $96 $44 Physical therapy $150.00 $97.00 $0 $19.40 $77.60 $19.40 X-ray $115.00 $73.00 $0 $14.60 $58.40 $14.60 MRI $1,845.00 $147.00 $0 $29.40 $117.60 $29.40 Specialty visit $165.00 $90.00 $40 $18 $72 $58 Specialty visit $75.00 $70.00 $40 $14 $56 $54 Lab test $32.00 $19.00 $0 $3.80 $15.20 $3.80 Lab test $45.00 $29.00 $0 $5.80 $23.20 $5.80 Mammogram $151.00 $95.00 $0 $19 $76 $19 Using the reimbursement information calculate: Coinsurance Copay amount, if any Amount insurance will pay How much the patient owes Based on the negotiated capitation amount, predict: Total amount of revenue per month $4,893,750 Total amount of revenue per year - $58,725,000 . Total profit expected per month - $913,500 Total profit expected per year - $10,962,000 An executive summary is a document or proposal that provides a brief overview or summary In this case, it is used to summarize the findings of your report. In a 1-page executive summary : . Summarize your reimbursement data. Determine what revenue to expect for each of the services the services. Summarize your prediction and forecasting data. Compare to the budgeted revenue. Explain potential reasons for budget variances

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Executive Summary Reimbursement Analysis Based on the provided reimbursement information the following calculations were made Coinsurance The coinsura... View the full answer