Sim Vouchering Case

Thus, in all of the Compensation Schedules, Aetna agreed to pay the Hospitals for “other implants” billed using revenue code 278 at the stated percent of billed charges carve-out rate, to be paid in addition to the other negotiated rates.

Claim: 133604438000 billed code 68811 w/ mod.50 is not on the Ambulatory Surgery Center Fee Schedule for POS 24. Please see attached.

The $3,000 deductible feature means that the insurance will not cover the first $3,000 of eligible expenses for the year (or possibly for each illness or accident in which Zach is involved, depending on the policy terms). The 80% coinsurance clause indicates that the insurer will pay only 80% of the amount of covered losses in excess of the deductible. The internal limit of $180 per day on hospital room and board indicates that the maximum the insurer will pay for hospital room and board is $180 per day. The internal limit of $1,500 on surgical fees indicates that the insurer will pay no more than $1,500 for such expenses.

4.1.1. The system must load the coupon into it database if the coupon is not

6. How does the current reimbursement level of $140,000 per case affect a decision to use or not use marginal cost pricing? Does the amount of excess capacity affect the decision? Why?

2. Velocity Cellular should allocate the $200 nonrefundable fee between the activation card and the airtime card (prepaid voucher). The activation card should be recognized as revenue at the point of purchase, while the airtime minutes should be recognized at their point of use (as revenue is earned).

ASC 420-10-25-15 states that liabilities for other costs associated with the exit or disposal activity (420-10-25-14) shall be recognized when the liability is incurred. In our case, liability related to the relocation cost of $500,000 and staff training cost of $1.5 million, must be recognized by Pharma Co. later, when these costs will incur.

E5-5 On March 12, Medical Waste Services provides services on account to Grace Hospital for 11000, terms 2/10, n/30. Grace pays for those services on March 20.

There is also something known as the coverage gap. For some plans, a patient can reach a

Sicker patients mean higher rates.  This is called a risk score.  The lawsuit alleged that the MA Plans overcharging were inflating the risk score.

From the first page of the case we have an estimate of $11 million cost of lost sales and backorders and $10 million associated with having too much of the wrong inventory. These costs are stated as being a conservative estimate.

Augustine could set premium prices on the heater/blower unit as well as the plastic/paper covers to induce a sense superior quality. Being that the Bair Hugger Patient Warming System is an answer to many of the drawbacks hospitals incur from other treatments, the value proposition of these products could very easily support this proposed pricing strategy.

Other interim charges include Charge IV: identifying cost-effective alternatives to Medicaid and ACA to provide health care to low-income individuals and Charge V: evaluate the Temporary Assistance for Needy Families program (Senate, 2014).

When considering requests such as a new piece of equipment, staff training, and supplies for the unit, a manager must consider the overall budget, constraints, and variances. If equipment has a useful life of more than one year and exceeds the minimum cost level of the facility, the manager may request the cost originates from the capital budget of the facility (Yoder-Wise, 2012). Large equipment such as a patient lift, which costs $3000 per lift, would be beneficial to the staff and

Based on a research Vodafone has done in 2014 there are more than 20 million Egyptian are using Vodafone as a SIM card and internet connection.