Question

diagnosis of Alzheimer’s disease. The charges for today total $360.00. Her husband reminds you that she has Medicare and a Medigap plan that picks up her 20% coinsurance after Medicare. You inform Mr. Evans that the office is a participating provider with Medicare. You bill Medicare and find out from the remittance advice (RA) that Nancy has $122.65 left on her deductible for this year.
Discussion Questions:
1. How much of the $360 bill for the neurology consult services will be Nancy’s responsibility? (Refer to the Insurance and Billing chapter if necessary.)

2. What is the best way to bill Nancy for this balance?

3. Why is this way the preferred method?

Description:
Nancy Evans is a 71-year-old female who has been referred to the neurologist because of a possible diagnosis of Alzheimer’s disease. The charges for today total $360.00. Her husband reminds you that she has Medicare and a Medigap plan that picks up her 20% coinsurance after Medicare. You inform Mr. Evans that the office is a participating provider with Medicare. You bill Medicare and find out from the remittance advice (RA) that Nancy has $122.65 left on her deductible for this year.
Discussion Questions:
1. How much of the $360 bill for the neurology consult services will be Nancy’s responsibility? (Refer to the Insurance and Billing chapter if necessary.)

2. What is the best way to bill Nancy for this balance?

3. Why is this way the preferred method?

Answer 1

1. A deductible is an amount that a person has to pay out of their pocket while getting a heathcare service that is covered in her insurance plan. Once the whole amount mentioned in their policy is payed, then the insurance provider starts paying any expenses after that. In case of Nancy she still needs to pay her deductible of $122.65 & then once that is paid off she pays nothing.

So she will pay $122.65 of the $360 bill for the neurology consult services.

2. The best way to bill Nancy for this balance is by asking her for the payment on the spot.

3. This is way the preferred method because this payment method brings income into the practice faster.