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{"id":171143,"date":"2021-10-12T14:37:03","date_gmt":"2021-10-12T14:37:03","guid":{"rendered":"https:\/\/nursingwritershelp.com\/?p=171143"},"modified":"2021-10-12T14:37:03","modified_gmt":"2021-10-12T14:37:03","slug":"assume-that-for-the-time-in-question-you-have-2000-cases-in-the-proportions-above","status":"publish","type":"post","link":"https:\/\/nursingwritershelp.com\/assume-that-for-the-time-in-question-you-have-2000-cases-in-the-proportions-above\/","title":{"rendered":"Assume that for the time in question you have 2000 cases in the proportions above."},"content":{"rendered":"<\/p>\n

Your facility has the following payer mix:
40% commercial insurances<\/p>\n

25% Medicare insurance<\/p>\n

15% Medicaid insurance<\/p>\n

15% liability insurance<\/p>\n

5% all others including self-pay<\/p>\n

Write a 3-4 page report that addresses the following requirements:<\/p>\n

Assume that for the time in question you have 2000 cases in the proportions above. (What are the proportions of the total cases for each payer?)<\/p>\n

The average Medicare rate for each case is $6200- use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare, Liability insurers average 200% of Medicare and the others average 100% of Medicare rates. (What are the individual reimbursement rates for all 5 payers?)<\/p>\n

    \n
  1. What are the expected rates of reimbursement for this time frame for each payer? What is your expected A\/R?<\/li>\n
  2. What rate should you charge for these services (assuming one charge rate for all payers)? (This gives you your total A\/R.) Calculate the total charges for all cases based on this rate.<\/li>\n
  3. What is the difference between the two A\/R rates above? Can you collect it from the patient? What happens to the difference?<\/li>\n
  4. Which of these costs are fixed? Which are variable? Direct or indirect?\n