Day Class Meets: using the Ratio of Cost to Charge Approach, determine the RCCs

Question

Day Class Meets: using the Ratio of Cost to Charge Approach, determine the RCCs by department, the estimated cost for listed charge codes, and the charges/cost for a patient healthcare bil 1. Calculate the Ratio of Cost to Charge (RCC) for each hospital department. ChargesCost $ 4,000,000 $16,589,000 $35,910,000 $ 6,789,000 RCC Department Laboratory Radiology Nursing Unit MRI $2,000,000 $15,673,000 $ 27,890,000 $8,712,000 2. Estimate the cost for each of the following charge or service codes Unit Charge $6,000 $4,200 $2,500 $400 $1,500 $1,500 RCC Estimated Cost Service Code Nursing Unit Level 3 Level 2 Level 1 Chest 2 View MRI Head MRI Abdomen Radiology MRI Determine both the Billed Charges and Estimated Cost for the following patient bill. Acount Service Code 3. Billed Charge per Est Cost Each Billed Charges Est Cost for Code Quantity Each code for Account Account $4,200 $ 400 $1,500 123456 Level 2 Chest 2 View MRI Head Total Bill For this patient bill, the patient's health plan contract indicates the hospital will be paid $22,500. What is the profit or (loss) for this patient's bill? Show calculation of Profit or (Loss) 4.

Explanation / Answer

Requirement 1 Department Charges Cost RCC Laboratory 4000000 2000000 50.00% Radiology 16589000 15673000 94.48% Nursing Unit 35910000 27890000 77.67% MRI 6789000 8712000 128.33% Requirement 2 Department Service Code Unit Charge RCC Estimated cost Nursing Level 3 6000 77.67% 4660 Level 2 4200 77.67% 3262 Level 1 2500 77.67% 1942 Radiology Chest 2 View 400 94.48% 378 MRI MRI Head 1500 128.33% 1925 MRI Abdomen 1500 128.33% 1925 Requirement 3 Account Service Code Bill Quantity Charge per Each code Est.Cost Each Code Billed Charges for Account Est. Cost for Account 123456 Level 2 5 4200 3262 21000 16310 Chest 2 View 1 400 378 400 400 MRI Head 2 1500 1925 3000 6000 Total Bill 24400 22710 Requirement 4 Profit or (Loss) for this patient's bill (22500-22710)           -210

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