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OIC - Applying Concepts Ch 2 #3

3. A patient in a POS plan has a $10 copayment and a 70-30 coinsurance rate on the balance of the charge. The patient is seen for an office visit; the total charge for the office visit is $85. What amount is owed by the patient?

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A copayment is basically a charge that you need to pay to get the service. In easy terms, if you have 70 30 coinsurance, as in the case, your insurance company will pay 70 percent of the amount. But they would start paying the amount only after you pay copayment fees.

To enable the insurance company to pay 70 percent of the amount, you need to pay 10 dollars first.

Now at the very beginning, the needs to pay 10 dollars as copayment. After that, he needs to pay 30 percent of 85 dollars bill, which is

85×30÷100 = 22.5 dollars.

Hence total money owed by him is 22.5+10 = 32.5 dollars.


answered by: Ctiverda
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