Evaluating Financial StatementsPart 1 Your facility has the following payer mix: 40% commercial insurances 25% Medicare insurance 15% Medicaid insurance 15% liability insurance 5% all others...

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Answered Same DayDec 31, 2021

Answer To: Evaluating Financial StatementsPart 1 Your facility has the following payer mix: 40% commercial...

David answered on Dec 31 2021
128 Votes
Part 1
1)
Payer Mix
No. of cases Rate per
case
Expected rate of
Reimbursement
Commercial insurances 40% 800 6200*1.10

= 6820
6820*800 =
54,56,000
Medicare insurance 25% 500 6200 6200*500 =
31,00,000
Medicaid insurance 15% 300 6200*0.65
= 4030
4030*300 =
12,09,000
Liability insurance 15% 300 6200*2.0
= 12,400
12,400*300 =
37,20,000
All others ( incl. self-pay) 5% 100 6200*1.0
= 6200
6200*100 =
6,20,000
Total 100% 2000 $ 14,105,000
Expected A/R = 14,105,000/2000 = $ 7052.50
2)
The rate charged for these services should be according to the schedule, Charge master
Payer Mix
No. of
cases
Charge Rate per
case (same for
Total Charges
all payers)
Commercial insurances 40% 800
14,105,000/2000
= $ 7052.50
7052.50*800
= 56,42,000
Medicare insurance 25% 500
14,105,000/2000
= $ 7052.50
7052.50*500
= 35,26,250
Medicaid insurance 15% 300
14,105,000/2000
= $ 7052.50
7052.50*300
= 21,15,750
Liability insurance 15% 300
14,105,000/2000
= $ 7052.50
7052.50*300
= 21,15,750
All others ( incl. self-pay) 5% 100
14,105,000/2000
= $ 7052.50
7052.50*100
= 705,250
Total 100% 2000 $ 14,105,000
3)
The major difference between the two A/R rates above is that one is the reimbursement rate
from the...
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