WK7 ASSIGNMENT1 HP-214

WK7 ASSIGNMENT1 HP-214

Health Insurance Calculations – Tricare Participating Provider

There is a video resource that demonstrates a similar scenario.  Ch. 11 Connect, #12 Tutorial  More information is available to you in Chapter 9 of your text.   

Use the attached assignment document to complete and submit for grading.Health Insurance Calculations – Tricare Participating Provider

There is a video resource that demonstrates a similar scenario. Ch. 11 Connect, #12Tutorial. More information is available to you in Chapter 9 of your text. Specific tips are:

· Participating provider receives the full amount listed on the Physician’s Fee Schedule (PFS).

· Limiting charge = the highest amount the provider can collect from the patient & insurance = PFS x 115%

Fill in the blanks in the following payment situations:

1A

Participating Provider no remaining deductible

Physician’s standard fee $ 320

TRICARE fee $ 235

Patient pays 20% $

TRICARE pays 80% $

Provider adjustment (write-off) $

1B

Participating Provider with a remaining deductible

Physician’s standard fee $320

TRICARE fee $235

Patient pays remaining deductible ($100) $

Patient pays 20% remaining charge of $

TRICARE pays 80% remaining charge $

Provider adjustment (write-off) $