Question

Calculate the financial responsibility of the carrier and the amount the physician must write off
1. Ginger Smith was seen in Dr. Sampson’s office today for an allergic reaction to a prescribed drug. Total charges today are $100. Allowed amount is $77.

_____________________ Discount amount ________________________ Carrier pays provider

2. Wesley Camp is having outpatient surgery at the Day Surgery Center. Mr. Camp is on a PPO plan. His benefits pay at 80%. Total charges today are $2400.56. Allowed amount is $1976.23.

_____________________ Discount amount ________________________ Carrier pays provider

3. Scott Snyder is being seen in Dr. Everready’s office today for hypertension. Mr. Snyder is on an HMO plan. Dr. Everready is an endocrinologist. Scott does not have a referral. Total charges today are $166. Allowed amount is $110.

_____________________ Discount amount ________________________ Carrier pays provider

4. Andrew Payne is having outpatient surgery at the Carrollton Surgery Center. Total charges are $2225. Allowed amount is $2000. Benefits pay at 40%.

_____________________ Discount amount ________________________ Carrier pays provider

5. Robin Hughes is being seen in Dr. Barry’s office today to have a toothpick removed from his toe. Total charges today are $125. Allowed amount is $95.

_____________________ Discount amount ________________________ Carrier pays provider

6. Douglas Jackson was seen in the doctor’s office today to remove a mole from his left cheek. Total charges today are $377. The allowed amount is $217. Benefits pay at 75%.

_____________________ Discount amount ________________________ Carrier pays provider

Answer 1

1. Ginger Smith was seen in Dr. Sampson’s office today for an allergic reaction to a prescribed drug. Total charges today are $100. Allowed amount is $77.

________________$_33____ Discount amount ___________$77_____________ Carrier pays provider

Discount=>100-77=33

Amount Paid= $77

2. Wesley Camp is having outpatient surgery at the Day Surgery Center. Mr. Camp is on a PPO plan. His benefits pay at 80%. Total charges today are $2400.56. Allowed amount is $1976.23.

________________$423.77_____ Discount amount ______________$1976.23__________ Carrier pays provider

Discount=>2400-1976.23=423.77

Amount Paid= $1976.23

3. Scott Snyder is being seen in Dr. Everready’s office today for hypertension. Mr. Snyder is on an HMO plan. Dr. Everready is an endocrinologist. Scott does not have a referral. Total charges today are $166. Allowed amount is $110.

__________________$56___ Discount amount __________$110______________ Carrier pays provider

Discount=>166-110=56

Amount Paid= $110

4. Andrew Payne is having outpatient surgery at the Carrollton Surgery Center. Total charges are $2225. Allowed amount is $2000. Benefits pay at 40%.

_______$225______________ Discount amount ___$2000_____________________ Carrier pays provider