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QUESTION
PLEASE CHOOSE JUST ONE OF THE FOLLOWING SCENARIOS TO RESPOND TO (ALTHOUGH YOU SHOULD TRY TO DO THEM ALL ON YOUR OWN).
- PLEASE CHOOSE JUST ONE OF THE FOLLOWING SCENARIOS TO RESPOND TO (ALTHOUGH YOU SHOULD TRY TO DO THEM ALL ON YOUR OWN). THIS PRACTICE WILL HELP YOU WITH THE BENCHMARK ASSIGNMENT SO IT IS VERY IMPORTANT THAT YOU KNOW HOW TO DO THIS. If you want to well on the assignment, you should understand how to do all calculations and if you have difficulty, you need to let me know as soon as possible because we may need to have a phone call to help you. If you need help, you must contact me no later than Sunday the day it is due before 6 p.m. central time zone.
- A patient with BCBS PPO coverage had surgical knee arthroscopy with medial and lateral meniscectomy. The plan has an 80-20 coinsurance with no copayment for surgical procedures. The annual deductible has been met. Total charges are $1000.00What will the plan pay, and what amount does the patient owe?
- A United patient has a high-deductible plan with a $1,200 deductible for this year that has not been met and 75-25 coinsurance. He has surgical knee arthroscopy with debridement. Total charges are $3200.00What will the plan pay, and what amount does the patient owe?
- Customer service is important across the revenue cycle. Pick one of the scenarios above and imagine that you are the billing specialist and Mr. Jones has called you about his bill because he does not understand it. Show the dialog (conversation) between the billing specialist and the patient. Show what each would say, keeping elements of customer service and the revenue cycle in mind. Be sure to discuss identification, verification, benefits, patient options such as rights to appeal or payment options, etc. and any other questions a patient may typically have. This is a very important exercise for you to do to prepare for the Benchmark assignement this week.
- Before calculating, make sure you have reviewed Chapter 8 p. 281, 284, and 293.
- Show your calculations. Make sure you show what the patient will pay and what the insurance will pay to the provider. If you are not confident with how to make calculations, there is math help available in the online library and you can also contact Tech Support or your adviser because this is essential to be able t do for this week's Benchmark Assignment
