MS-DRG Calculations Ex 202022 Ch 5 $$$$$$

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J. Explanation of Benefits XYZ Insurance Company Explanation of Benefits Walden-Martin Family Medical Clinic 1234 Anystreet Anytown, AK 12345-1234 Patient Treatment CPT Name Dates Code Yan, Tai 01/06/20XX (99205 01/06/20XX 01/06/20XX Totals Gomez, 01/07/20XX Pedro Totals 82947 86580 99212 * Amount Charge Reason Covered Deductible Co-Pay Code Amount Amount Amount Paid At 132.28 03 15.00 11.34 158.62 28.55 28.55 70.92 01/04/20XX 71020 Totals Green, 01/04/20XX 99203 Jana 40.97 111.89 Reason Code: 03 Allowed amount per insurance contract 03 03 125.00 15.00 11.34 151.34 28.55 28.55 69.23 34.95 104.18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Copyright © 2020, Elsevier Inc. All Rights Reserved. 80% 80% 80% 0.00 80% 0.00 80% 0.00 80% 01/20/20XX Payment Amount 100.00 12.00 9.07 121.07 22.84 22.84 55.38 27.96 83.34 Check No: 56390 $227.25 Using the explanation above answer the following questions: 1. For Tai Yan's office visit, 99205, there is a difference between the Charge Amount and…

H3. Sacramento Memorial Hospital has the following financial data and operational metrics: Number of beds--> 250 Total inpatient stays--> 12,250 Total outpatient visits--> 90,754 Total patient revenues--> $111,900,050 Outpatient mix--> 16.2% Medicare payment percentage(revenues)--> 28.0% Average length of stay--> 5.8 days Net price per discharge--> $7,653 Cost per discharge--> $6,292 f. What is the hospital’s occupancy rate? (Hint: Start by calculating available bed days.)    Show proper step by step calculation

(CO B) What percent of revenue do for-profit hospitals deliver in uncompensated care? O3%-4% O 10% 15%-20% None

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Table 7. Twenty leading principal reasons for outpatient department visits: the United States, 2009 All visits ... 96,132 Progress visit, not otherwise specified:9,052 General medical examination:  5,762 Cough:  2,638 Counseling, not otherwise specified: 2,550Prenatal examination, routine: 2,410 Medication, other and unspecified kinds: 2,282 Symptoms referable to throat: 1,773 Back symptoms :  1,630 Postoperative visit:  1,593 Diabetes mellitus :  1,568 Fever: 1,341 Knee symptoms:  1,331 Earache or ear infection: 1,326 Stomach pain, cramps and spasms:  1,231 Well-baby examination: 1,198 Headache, pain in head: 1,091 Low back symptoms: *1,078 Hypertension:  1,078 Skin rash: 1,053 Gynecological examination: 1,032 All other reasons ... 53,115  Table 9. Twenty leading principal reasons for office visits, by patient’s sex: the United States, 2018The principal reason for the visit All visits . . . . .860,386 (37,935) Progress visit, not otherwise specified . . . 151,669General medical…

Q4- The following information is extracted from Gamma Hospital's financial records. Patient accounts receivable, net Patient service revenue, gross Provision for contractual adjustments 14,000,000 97,000,000 12,000,000 Required: Compute the number of days' revenue in patient accounts receivable.

14. You have a 70/30 medical insurance policy with a $1,500 premium and a $800 deductible. You have medical expenses totaling $3,600. What is the cost to the insurance company for the loss? $1,605 $1,960 $2,100 $2,850 5: C lo nir

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Assume that Valley Forge Hospital has only the following three payer groups: Number of Average Revenue Variable Cost Admissions per Admission per Admission Commercial 1,000 $5,000 $3,000 PennCare 4,000 4,500 4,000 Medicare 8,000 7,000 2,500 The hospital's fixed costs are $38 million. a. What is the hospital's net income? b. Assume that half of the 100,000 covered lives in the commercial payer group will be moved into a capitated plan. All utilization and cost data remain the same. What PMPM rate will the hospital have to charge to retain its Part a net income? c. What overall net income would be produced if the admission rate of the capitated group were reduced from the commercial level by 10 percent? d. Assuming that the utilization reduction also occurs, what overall net income would be produced if the variable cost per admission for the capitated group were lowered to $2,200?

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215T 55209796/chapter/6/section/1 ntitative Reasoning I home > 6.1: Personal finance E zyBo Monthly, Val's net earnings are $4,500, and expenses are $4,000. How much should Val have in savings for a 3-month emergency fund? $ Ex: 12345 : 2. Check Next Provide feedback assignment: Wk 5 - Readings and Assignments [due Mon] EST 29/1

According to the Government Accountability Office, fraud and abuse account for nearly. health care. Multiple Choice о O O O 10% 11% 15% 20% 25% Home percent of all dollars spent on

Julie paid a day care center to watch her two-year-old son while she worked as a computer programmer for a local start- up company. What amount of child and dependent care credit can Julie claim in 2021 in each of the following alternative scenarios? Use Exhibit 8-10 b. Julie paid $5,650 to the day care center and her AGI is $52,600 (all salary). Child and dependent care credit

QUESTION 12 Abeer has a major medical pblicy with a 5200o deductible. She is required to pay 25 percent of covered expenses in excess of the deductble. The insurer will pay 75 percent of expenses in excess of the deductble. f Abeer has eligible medical expenses of $10.000. how much will be pad by her insurer? Da57.300 Ob. $7.500 C S0.800 Cd. $7.350

NOT A GRADE THIS IS A STUDY GUIDE.  Only need help on Part III  Goal is to save for a Prius Gross monthly income and net monthly income provided