After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00, 13.00, 13.50, 13.42, etc.
Case Study 16.8
Patient: Lakshmi Prasad
The practice receives the following information on an RA from Medicare Nationwide. The patient has met the deductible for 2029.
POS PROC BILLED ALLOWED DEDUCT COINS/COPAY PROV PD
11 99397 120.00 118.00 0.00
23.60 94.40
Patient balance: $
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
After the insurance carrier makes a decision on a claim and the practice receives and posts the payment, the patient’s balance must be calculated. The claim case studies in this section provide practice in calculating balances by providing the latest payment information obtained from RAs for each patient in Chapter 15, Claim Cases 15.1 through 15.20. Based on the payment information from the RA, you must calculate each patient’s balance. All answer amounts should have dollars and cents, i.e. 0.00,...
When a practice receives an RA from a carrier, the payment received for each procedure is posted to each patient’s account. If any patients on the RA have secondary coverage, secondary claims are then prepared unless they have automatically crossed from the primary to the secondary payer. Before doing so, however, the practice analyzes the RA to make sure the payments received are in keeping with what is expected given the office’s fee schedule, the patient’s insurance plan, and any...
When a practice receives an RA from a carrier, the payment received for each procedure is posted to each patient’s account. If any patients on the RA have secondary coverage, secondary claims are then prepared unless they have automatically crossed from the primary to the secondary payer. Before doing so, however, the practice analyzes the RA to make sure the payments received are in keeping with what is expected given the office’s fee schedule, the patient’s insurance plan, and any...