1. Once the patient's responsibility has been determined , from the primary insurance EOB, what is...
1. Once the patient's responsibility has been determined , from the
primary insurance EOB, what is the next step for the medical biller
to take?
2. What information might be found found in the Remarks codes on the EOB?
3. Describe a coinsurance of 70/30 ratio.
4. Explain patient financial obligations for services rendered.
Homework Answers
1. ANS: The next step for the medical biller is to check and observe the health record of the patient to see the secondary insurance was listed and if it is submit a second claim.
2. ANS: The Remarks codes on the EOB can indicate the terms and conditions under which the claim was paid.
3. ANS: The coinsurance ratio 70/30 can explains the allowable amount was covered 70% by the insurance and the remaining 30% was covered by patient.
4. ANS: The patient
is responsible for:
copay before services rendered
deductible until it has been met
coinsurance for every service (until the maximum out of pocket has
been met)
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