Question

2. Alfred State Medical Center's charges, payments, and adjustments from third-party payers for the month of July are represented in table W7.1: Table W7.1 Payer Charges Payments Adjustment Charges Payments Adjustments BC/BS $450,000 $360,000 $90,000 Commercial $250,000 $200,000 $50,000 Medicaid* $350,000 $75,000 $275,000 Medicare $750,000 $495,000 $255,000 TRICARE* $150,000 $50,000 $100,000 Totals $1,950,000 $1,180,000 $770,000 100% 100% 100% * Managed care capitated payment for period a. Calculate the percentage of charges, payments, and adjustments for each third-party payer and enter the percentages in the percentages columns of table 7W1. b. Based on the percentages calculated in the charges column, identify the payer the facility does the most business with and the payer it does the least business with. c. Based on the percentages calculated in the payment column, identify the payers that reimburse the facility the most and the least. d. Based on the percentages calculated in the adjustments column, identify the payers that proportionately reimburse the facility the most and the least.

Answer 1

a. ANS:

b. ANS: Based on the percentages calculated in the charges column, identify the payer the facility does the most business with and the payer it does the least business with. Medicare most, andTRICARE the least

c. ANS: Based on the percentages calculated in the payment column, identify the payers that reimburse the facility the most and the least. Medicare does the most, and TRICARE does the least.

d. ANS: Based on the percentages calculated in the adjustments column, identify the payers that proportionately reimburse the facility the most and the least. Medicaid and Commercial