Question

Problem 6: Mrs. Smith, a Medicare patient, had surgery, and the participating physician's fee is $1250. This patient is working part-time, and her employer group health plan (primary insurance) allowed S1100, applied S500 to the deduct ible, and paid 80% of S600. a. Amount paid by this plan: S b. The spouse's employer group health plan (secondary insurance) is billed for the balance, which is This program also has a $500 deductible. This plan pays 100% of the fee billed, minus the deductible c. The spouse's employer group plan makes a payment of You send copies of the remittance advice from the two group health plans and submit a claim to Medicare (the third insurance) for $1250. The balance at this point is. Mathematical computations: Problem 7: Beverly James has Medicare Part B coverage. She has $242 in medical bills and has met $100 of the $147 (2013 deductible). Dr. Practon agrees to accept assignment. Original Bill a. Medicare allows $200. Medicare payment: b. Beverly James owes Dr. Practon: c. Dr. Practon's courtesy adjustment: Mathematical computations:

Answer 1

6)

a) amount paid by the plan $980

b)the spouse of the employer billed for the balance which is  $270

c) $270

7)