ReimbursementQuestion 67 of 100
A deductible is:
a.The amount a patient must pay out of pocket each benefit period before the plan begins to pay
b.A percentage of every bill paid by the plan
c.The provider's billed charge
d.The maximum the plan will ever pay
Explanation
The deductible is the fixed amount the insured must pay for covered services each benefit period before the insurer starts sharing costs. After the deductible is met, the patient typically owes only copays or coinsurance up to the out-of-pocket maximum. Verifying the remaining deductible helps the practice collect the correct amount.
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Related questions on this topic
- A patient has a $1,500 medical bill, an allowed amount of $1,000, has already met the deductible, and has a 20% coinsurance. How much is the patient's coinsurance responsibility?
- A patient with a $500 remaining deductible receives a service with an allowed amount of $800 and 20% coinsurance after the deductible. What is the total patient responsibility?
- A copayment (copay) is best described as:
- The Resource-Based Relative Value Scale (RBRVS) determines physician payment based on:
- In the Medicare Physician Fee Schedule, the payment for a service is calculated by:
- Diagnosis-Related Groups (DRGs) are used mainly to determine reimbursement for:
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