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How much should cigna have paid

Assignment Help Macroeconomics
Reference no: EM132878962 , Length: 3

As you are completing your audits you observe Mary Johnson's chart and notice the following:

Mary Johnson saw Dr. Nichols today for a well-woman exam. Total charges are $185.00. Mary has two insurance companies:

  • Primary Insurance
  • Secondary Insurance
  • BCBS
  • Cigna Health Care

Copay: $25.00

Deductible: $200.00 (already met)

100% benefit after copay

80% benefit after deductible

Allowed amount: $150.00

Allowed amount: $125.00

Both claims were submitted at the same time in error.

Money collected from the patient: $0.00

Complete the following questions providing rationales for your responses:

Question 1: How much money did Dr. Nichols receive?

Question 2: How much should BCBS have paid?

Question 3: How much should Cigna have paid?

Question 4: How much is this claim overpaid?

Question 5: Who overpaid on this claim?

Question 6: What would be your next steps?

Reference no: EM132878962

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