Reimbursement第 64 / 100 题
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.$300, which is 20% of the billed charge
b.$500, the difference between billed and allowed
c.$200, which is 20% of the $1,000 allowed amount
d.$1,000, the full allowed amount
解析
Coinsurance is calculated on the allowed amount, not the provider's billed charge, so 20% of $1,000 equals $200. The $500 difference between the $1,500 charge and the $1,000 allowed amount is a contractual adjustment for a participating provider. The payer would pay the remaining $800 of the allowed amount.
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