How much of this bill will the employee pay directly

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A radiology group invests in a state-of-the-art MRI ($2 million). In addition to equipment, the group employs technicians who administer the procedure and a radiologist interprets the results. They set a price of $2600 for a typical MRI scan. This includes the professional fee (physician) and technical fee (procedure). They have an agreement with a third-party payor that pays 80 percent of the allowed charge. If the allowed charge is $2200, what would the insurance reimburse and what would the patient be expected to pay? What if the practice raised the fee to $2800. How much would the beneficiary pay?

Explain adverse selection and moral hazard in terms of the healthcare benefits that provide options for medical services. Apply this to a situation where an employee incurred a medical bill of $10,000. The benefit plan has a deductible of $1,000 and coinsurance of 20 percent. How much of this bill will the employee pay directly?

Reference no: EM133639578

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