What are the proportions of the total cases for each payer

Reference no: EM131551704

Assignment

Your facility has the following payer mix:

40% commercial insurances
25% Medicare insurance
15% Medicaid insurance
15% liability insurance
5% all others including self-pay

Write a 3 page report that addresses the following requirements:

Assume that for the time in question you have 2000 cases in the proportions above. What are the proportions of the total cases for each payer?

The average Medicare rate for each case is $6200- use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare, Liability insurers average 200% of Medicare and the others average 100% of Medicare rates. (what are the individual reimbursement rates for all 5 payers?)

1. What are the expected rates of reimbursement for this time frame for each payer? What is your expected A/R?

2. What rate should you charge for these services (assuming one charge rate for all payers)? (This gives you your total A/R.) Calculate the total charges for all cases based on this rate.

3. What is the difference between the two A/R rates above? Can you collect it from the patient? What happens to the difference?

4. Which of these costs are fixed? Which are variable? Direct or indirect?

o materials/supplies (gowns, drapes, bedsheets)
o Wages (nurses, technicians)
o Utility, building, usage exp (lights, heat, technology)
o Medications
o Licensing of facility
o Per diem staff
o Insurances (malpractice, business etc.)

5. Calculate the contribution margin for one case (in $) with the following costs for this period, per case: a. materials/supplies: $2270 b. Wages: $2000 c. Utility, building, usage exp: $1125 d. Insurances (malpractice, business etc.): $175

6. Using the above information, determine which is fixed and which cost is variable. Then calculate the breakeven volume of cases in units for this period.

7. Suppose you want to make $150,000 profit between this period and next period to fund an expansion to the NICU, how many cases would you have to see? At what payer mix would this be optimal?

Reference no: EM131551704

Questions Cloud

Write the report on global racism mostly american : Write the report on Global Racism mostly American. Developing a proposal is one of the first steps in an academic research process.

What is the toxic shock syndrome : A 22 year old diabetic with poor control of blood glucoses comes into clinic with a 2 month history of nasal congestion and low grade fever.

Discuss the most common clinical syndrome : Which of the following is the most common clinical syndrome associated with Mycoplasma pneumoniae?

How will you benefit if you succeed in your quest : Every hero has a trusty steed that takes him/her forward in the quest. What/Who is your trusty steed? Be very specific.

What are the proportions of the total cases for each payer : Assume that for the time in question you have 2000 cases in the proportions above. What are the proportions of the total cases for each payer?

Discuss the heisenberg uncertainity principle : Define electronegativity and electron affinity. How does it vary in a group and period of periodic table.

What is the estimated value of bond x using matrix pricing : What is the estimated value of Bond X using matrix pricing? What is the 18-month spot rate? What discount margin is reflected in the FRN's price?

The new york-historical society exhibit : In the North where large scale farming was limited and more urban centers existed, slaves were more likely to live and work in closer proximity to whites.

Establish validity and reliability to the research : Researchers note that although multiple cases are preferred there is no set number of units to be researched. The units researched depend on the numbers.

User Account

All Pages