A non-participating physician provides services to a Medicare patient who has total charges of $100 (before Medicare’s limiting charge is applied).

 

  1. A non-participating physician provides services to a Medicare patient who has total charges of $100 (before Medicare’s limiting charge is applied). The physician does not accept assignment, charges the maximum allowable, and submits the claim to Medicare. Assume Medicare’s approved schedule for these services is $80.
    • What is the maximum amount the physician is allowed to charge the patient?
    • What is the Medicare portion of the physician payment (which Medicare sends to the patient)?
    • What is the patient’s portion of the payment to the physician (net of the reimbursement from Medicare in the previous question)?
    • Would the physician have been better off by accepting assignment on this case? Why or why not?
  2. How do a high percentage of Medicaid (not Medicare) patients influence a hospital’s prices?

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

KRYSTEL BERGHER PROFILE Accomplished Customer Service Expert committed to the delivery of quality service. Professional and Ethical.

KRYSTEL BERGHER PROFILE Accomplished Customer Service Expert committed to the delivery of quality service. Professional and Ethical. Seeking to assist or help a new customer service department in creating and achieving the much-needed customer service goals. CONTACT ADDRESS: 15851 Southwest 139th Place, Miami FL 33177. PHONE: 305-992-6010 EMAIL: [email protected] om

Business Law BUS 3301 VII Question 12 The principal agent relationship, the employer-employee relationship, and the employer-independent contractor

Business Law BUS 3301 VII Question 12 The principal agent relationship, the employer-employee relationship, and the employer-independent contractor relationship are three types of agency relationships commonly found in business settings. Why is it important for business professionals to know what type of agency relationship they are forming?   Your response must

pfa TASK 1: By Tuesday Evening Reflection and Discussion Forum Week 3

pfa TASK 1: By Tuesday Evening Reflection and Discussion Forum Week 3 Assigned Readings: Chapter 8. Understanding Markets and Industry Changes. Chapter 9. Market Structure and Long-Run Equilibrium. Chapter 10. Strategy: The Quest to Keep Profit from Eroding. Initial Postings: Read and reflect on the assigned readings for the week.