Question

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 16.12

Patient: Nancy Lankhaar

 

The practice receives the following information on two different RAs. The first payment is from Medicare, the primary payer. The patient has met the Medicare deductible. The second payment is from AARP, the secondary carrier.

 

PRIMARY CARRIER

POS            PROC            BILLED            ALLOWED            DEDUCT            COINS/COPAY            PROV PD

11                99212            46.00                 28.00                    0.00                     5.60                           22.40

 

SECONDARY CARRIER

POS            PROC            BILLED            ALLOWED            DEDUCT            COINS/COPAY            PROV PD

11                99212            46.00                 28.00                    0.00                     0.00                             5.60

 

Patient balance: $ 

Answer 1

PATIENT	PATIENT BALANCE
Nancy Lankhaar	$0