Gary Tuttle has Citiwide Insurance with 100% coverage after a $25.00 copay on office visits. His services today include an office visit ($62.00), urinalysis with differential ($65.00) and a Treadmill ECG ($155.00), which were billed to his insurance company. The insurance approved/allowed $255.00 and paid 100% of the approved/allowed amount minus the copay already paid by the patient; answer the following:
11. How much is the copay? __________________________
12. How much is adjusted? __________________________
13. How much is the payment from the insurance company? ___________________________

Respuesta :

11. The amount of COPAY is $25.00

COPAY can be defined as the amount which the person  that was been INSURED by the insurance company which is  Gary tuttle paid to the  insurance company (Citiwide Insurance) for insurance coverage.

Hence, The amount of COPAY will be $25.00 COPAY on office visits which was 100% paid.

12. The adjusted amount is $2.00

Using this formula

Adjustment= (Office visit+Urinalysis+Treadmill ECG)-(Insurance approved/allowed+Copay)

Let plug in the formula

Adjustment=($62+$65+$155)-($255+$25)

Adjustment=$282-$280

Adjustment=$2.00

Hence, eadjusted amount is $2.00

13. The payment from the insurance company is $255.

The payment from the insurance company will be $255 which represent the insurance approved/allowed by insurance company which was 100% paid.

In conclusion the copay amount is $25, Adjusted amount is $2.00 and the payment from the insurance company will be $255.

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