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 16.11 Patient: Andrea Spinelli The practice receives the following information on an RA from the Medicare HMO plan. The patient made a $10 copay at the time of the visit. POS PROC BILLED ALLOWED DEDUCT COINS/COPAY PROV PD 11 69210 63.00 34.00 0.00 10.00 24.00 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,...
The Medicare HMO plan sent the practice an RA as shown in Figure 16.1.Locate the claim for Wendy Walker in the remittance advice (RA). Notice that the claim has been denied. 1. What reason is given for the rejected claim? What procedure has been billed in the claim? 2. Refer back to the encounter form for Wendy Walker in Claim Case Study 15.1. Does the encounter form contain the same procedure code that is listed in the RA? 3. Refer next to the patient...
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...