Question

Assignment Details - This is a 5 part deliverable

PART 1

Your facility has 2000 cases in the following payer mix:

• 40% commercial insurances
• 25% Medicare insurance
• 15% Medicaid insurance
• 15% liability insurance
• 5% all others, including self-pay

What are the proportions of the total cases for each payer?

PART 2

The average Medicare rate for each case is $6,200. Use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare., Lliability insurers average 200% of Medicare, and the others average 100% of Medicare rates.

1. Calculate the individual reimbursement rates for all 5 payers?
2. What is your expected Accounts Receivable?

PART 3

Which of the following costs are fixed, which are variable, and which are direct or indirect:

• Materials/supplies (gowns, drapes, bedsheets)
• Wages (nurses, technicians)
• Utility, building, usage exp (lights, heat, technology)
• Medications
• Licensing of facility
• Per diem staff
• Insurances (malpractice, business, and so on)

PART 4

Given the following costs per case:

• Materials/supplies: $2,270
• Wages: $2,000
• Utility, building, usage exp: $1,125
• Insurances (malpractice, business, and so on): $175

What is the total cost of all combined cases?

PART 5

Calculate the difference between accounts receivable (A/R) and accounts payable (A/P)

Answer 1

A.

		Working	No. of cases held
Commercial insurance	40%	=2000*25%	800
Medicare insurance	25%	=2000*25%	500
Medicaid insurance	15%	=2000*15%	300
liability insurance	15%	=2000*15%	300
others including self-pay	5%	=2000*5%	100
Total number of cases			2000

B.

Average rate of Medicare	$ 6,200.00
	Average	individual rate = 6200* average	individual reimbursement rate
Commercial insurance	110%	6200*110%	6820
Medicare insurance	65%	6200*65%	4030
Medicaid insurance	100%	6200*100%	6200
liability insurance	200%	6200*200%	12400
others including self-pay	100%	6200*100%	6200

C. generally the following is correct

	Fixed / variable	Direct/ indirect
Materials/supplies (gowns, drapes, bed sheets)	Fixed	Indirect
Wages (nurses, technicians)	Fixed	Indirect
Utility, building, usage exp (lights, heat, technology)	Fixed	Indirect
Medications	Variable	Direct
Licensing of facility	Fixed	Indirect
Per diem staff	Variable	Direct
Insurances (malpractice, business, and so on)	Fixed	Indirect

4.

Materials/supplies (gowns, drapes, bedsheets)	2270
Wages (nurses, technicians)	2000
Utility, building, usage exp (lights, heat, technology)	1125
Insurances (malpractice, business, and so on)	175
Total Cost	5570

	No. of cases held	Cost per case	Total cost
Commercial insurance	800	5570	$           44,56,000
Medicare insurance	500	5570	$           27,85,000
Medicaid insurance	300	5570	$           16,71,000
liability insurance	300	5570	$           16,71,000
others including self-pay	100	5570	$             5,57,000
Total number of cases	2000		$       1,11,40,000

total cost = $11,140,000.