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Healthcare revenue management

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Reference no: EM132607187

A patient has a $500 deductible that she has not met this year. She has 80% insurance coverage (of allowed charges) once the deductible has been satisfied. The charge for the initial visit today is $650, and the insurance plan covers the entire amount ($650). Now that you have read the required reading, consider the following questions:

1. How much should the patient pay? Explain why. In addition, explain if the amount the patient should pay would be different if she was a new patient or a current patient, and explain why.

2. What will be her remaining balance for the next visit this year, which is expected to have a charge of $300? Explain why.

3. Guessing that the patient in the case study has a managed care policy, what type of policy does she most likely have? Explain why.

4. What terminology would a healthcare insurance specialist use to describe the portion of the payment that is calculated on 20% of the charges?

5. If the healthcare insurance specialist did not know if the deductible had been satisfied, what procedure should he or she follow? Explain why this procedure is important for healthcare revenue management.

Reference no: EM132607187

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