A non-participating physician provides services to a Medicare patient who has total charges of $100 (before Medicare’s limiting charge is applied). The physician does not accept assignment, charges the maximum allowable, and submits the claim to Medicare. Assume Medicare’s approved schedule for these services is $80. A. What is the Medicare portion of the physician payment (that Medicare sends to the patient)? B. What is the patient’s portion of the payment to the physician (net of the reimbursement from Medicare in the information above?
Doctor charge $100
Medicare approved 80
x participating factor 0.95
Medicare allowed 76
x MAC factor 1.15
Max allowable charge 87.4
Medicare payment (80%) 69.92
Patient Payment 17.48
Total allowed 87.4
A. What is the Medicare portion of the physician payment (that Medicare sends to the patient)?
B. What is the patient’s portion of the payment to the physician (net of the reimbursement from Medicare in the information above?
3. Use the information and table below to solve problems 3A and 3B. The Medical College of Virginia, located in the urban city of Richmond, Virginia, has a wage index of 1.8579. A student from nearby Virginia Commonwealth University has just been treated for viral meningitis during a five-day length of stay (LOS), (DRG weight: 1.535). Rate Table Hospital Status Labor Non-labor Urban Areas 2,800 1,250 Rural Areas 2,000 1,000 A. Calculate the DRG operating payment for this treatment. B. Assuming that the wage index remains the same, what would the DRG operating payment be if the same treatment occurred in the rural Pulaski County Hospital in Pulaski, VA?
A. Calculate the DRG operating payment for this treatment.
B. Assuming that the wage index remains the same, what would the DRG operating payment be if the same treatment occurred in the rural Pulaski County Hospital in Pulaski, VA?
Why Work with Us
Top Quality and Well-Researched Papers
We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.
Professional and Experienced Academic Writers
We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.
Free Unlimited Revisions
If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.
Prompt Delivery and 100% Money-Back-Guarantee
All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.
Original & Confidential
We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.
24/7 Customer Support
Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.
No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.
Admission Essays & Business Writing Help
An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.
Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.
If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.