You are Accounts Receivable manager for General Medical Center (GMC). Your assig
ID: 2545660 • Letter: Y
Question
You are Accounts Receivable manager for General Medical Center (GMC). Your assignment is to determine the amount of payment GMC would collect from Best Managed Care (Best) under differ was ent payment methods. The following patient admitted to GMC. Use the information for this patient's accounts to calculate the payment amount to be collected by GMC for different payment methods. Patient Account: 12345 Admit Date: February 10, 2017. Discharge Date: February 14, 2017. Billed Charges: $30,000 Length of Stay 4 Diagnostic Related Group (DRG):456 Cardiac Bypass Patient Name: Joe Limbo Answer the following payment method questions. You MUST show your work or you will not be given credit for the answer. Assume Best's contract states that Best pays 100% of billed charges. How much would GMC collect for the above patient account? 1. Assume Best's contract states that Best is to receive a 25% discount on billed charges. How much would GMC collect for the above patient account? 3, Assume GMC's ratio of cost to charge is 40% and that Best's contract states that Best is to pay GMC at cost. How much would GMC collect for the above patient account? Assume Best's contract states that Best pays on a per diem basis and that Best's contract rate is $4,500 per day of stay. How much would GMC collect for the above patient account? 4. 5 Assume Best's contract states that Best pays based on per case or diagnosis (DRG). Best's contract fee schedule indicates the rate Best is to pay for DRG 456 Cardiac Bypass is $6,725. How much would GAMC collect for the above patient account?Explanation / Answer
1. Since 100% of billed charges, amount expected to receive will be 30000 x 100% = $30000
2. In case of 25% discount on billec charges, GMC will receive = 30000 x (100-25)% = $ 22500
3. If BEST will pay at cost, then cost of GMC in this transaction is 40% of 30,000 = 12000. Hence GMC will receive $12000.
4. Since the rate of per diem stay is $4500 per day and the patient stayed for 4 days, amount receivable will be 4500 x 4 = $18000
5. Since the rate per diem in case of DRG 456 Cardiac Bypass is $6725 and total stay for this case for 4 days, amount receivable will be 6725 x 4 = $26900
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