Worksheet # 13 Using the Fee schedule to calculate billing charges. (5 points each) How to do this assignment is in the guide here: Lesson #13 how to guide.docx

Calculate the charges for these patients using Dr. Larsens Fee Schedule attached to this assignment. Show and explain any calculations.

1. Jane Jones is an established patient with Dr. Larsen. She is 44 years old and wants to schedule an appointment to have her annual blood work done and to get her flu shot for seasonal influenza. Her routine blood work will include a basic metabolic panel and a lipid panel. She is worried because she has lost her insurance and must pay cash for her medical expenses. She asks you what the charge will be for the office visit. You calculate that her charge will be ________.

2. John Smith has a commercial insurance plan with an annual $500 deducible which he has met. His office copayment is $20 for PCP appointments. He is 54 years old and is an established patient. He schedules an appointment to have his annual blood work done and to get a flu shot for seasonal influenza. His routine blood work will include a basic metabolic panel and a lipid panel. He asks you what the charge will be for the office visit. You calculate that his charge will be ________. ( and explain.)

3. Patricia Patient is 70years old has Medicare Plan B for outpatient coverage, but she has no supplement to cover the 20% not paid by Medicare B. She has met her deductible of $182 for Medicare B for the year. She schedules an appointment to have her annual blood work done and to get her flu shot for seasonal influenza. Her routine blood work will include a basic metabolic panel and a lipid panel. What would be the usual charge for these services?

4. The amount that Medicare sets as the allowable amount for the services for Patricia Patient in #3 is $127. How much of this would Patricia owe? (HINT: Medicare B is an 80/20 co-insurance model.) What happens to the difference between the usual charge calculated from the fee schedule and the amount reimbursed?

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