Alfred State Medical Center’s charges, payments, and adjustments from third-party payers for the month of July are represented in the table below. As part of your responsibility as a member of the Revenue Cycle Performance Committee, you are required to monitor various component of the revenue cycle and report your findings to the committee. The committee uses your report to determine new and continued contracts with specific payer types.
In preparation for your report you must calculate and analyze the data.
|
Payer |
Charges |
Payments |
Adjustment |
Charges |
Payments |
Adjustments |
|
BC/BS |
$450,000 |
$360,000 |
$90,000 |
|
|
|
|
Commercial |
$250,000 |
$200,000 |
$50,000 |
|
|
|
|
Medicaid |
$350,000 |
$75,000 |
$275,000 |
|
|
|
|
Medicare |
$750,000 |
$495,000 |
$255,000 |
|
|
|
|
TRICARE |
$150,000 |
$50,000 |
$100,000 |
|
|
|
|
Totals |
$1,950,000 |
$1,180,000 |
$770,000 |
100% |
100% |
100% |
Example of how to complete
IF you’re having problems with Module 11 Assignment, I hope this helps.
|
|
Payer |
Charges |
Payments |
Adjustment |
Charges |
Payments |
Adjustments |
||
|
|
BC/BS |
$450,000 |
$360,000 |
$90,000 |
23% |
|
|
||
|
Totals |
$1,950,000 |
$1,180,000 |
$770,000 |
100% |
100% |
100% |
|||
What you’re doing is calculating the percentage of eachpayer charges, payments and adjustments.
$450,000 / $1,950,000 = 0.2307 x 100 = 23%
$360,000 / $1,180,000 = xxx x 100 = xxx %
$90,000 / $770,000 = xxx x 100 = xxx %
Repeat these steps for each payer. Then complete the work for questions b, c and d.
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