Medical Insurance - Math
Can earn RHIA or RHIT certification; work in office practices, nursing homes, home health agencies, & public health agencies
Health information certificate
What type of health plan is described: HMO, PPO, or Indemnity
PPO
What is the annual premium?
W
The patient is enrolled in a capitated HMO with a $10 copayment for primary care physician visits and no coinsurance requirements. After collecting $10 from the patient, what amount can the medical insurance specialist bill the payer for an office visit?
$0
What is the annual deductible?
$2,500
The patient's coinsurance percentage is stated as 80-20 in the insurance policy. The deductible for the year has been met. If the visit charges are $420, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed?
$336 ins; $84 patient
The patient's coinsurance percentage is stated as 75-25 in the insurance policy. The deductible for the year has been met. If the visit charges are $1,000, what payment should the medical insurance specialist expect from the payer? What amount will the patient be billed?
$750 ins; $250 patient
The patient's health plan has a $100 annual deductible. At the first visit of the year, the charges are $95. What does the patient owe?
$95
Can earn the title CMA or RMA
Medical assisting certifiaction
Steps of the Medical Billing Cycle
Preregister patients establish financial responsibility check in patients review coding compliance review billing compliance check out patients prepare and transmit claim monitor payer adjudication generage patient statement follow up payments & collect
Experts in classifying medical data, inlcudes CCA, CCS, CCS-P, CPC, CPC-H, CPC-P, CPC-H certifiacate
coding certification
REquired by most professional organizations
continuing education