Explanation Benefits Assignment Question & Answer Guide (With Explanation)
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Original Question
Explanation of Benefits Assignment Excellent Healthcare Insurance Company Date: 08/19/201* Patient’s Name: Cathy Smith (Member) ID Number 123456789 Date: 07/13/201* Line Service Charge Cont. Other Allowable Co- Benefit Allowance Adjustment Charge Insurance Payment 1 Appendectomy $1045.00 $812.88 $0.00 $232.12 $46.42 $185.70 2 Face Lift $1320.00 So $0.00 $0 $1320.00 So W Preventive $890.00 $890.00 $0.00 $890.00 $0 $850.00 Colonsocopy Totals $3255 $1702.88 $0.00 $1122.12 $1366.42 $1035.70 $500 of $500 Deductible met as of 06/30/201* Review the above chart and answer the following questions: Excellent Healthcare covers surgeries at 80% Preventive procedures covered at 100% Cosmetic procedures are not covered 1. If the patient’s insurance plan plays 80% of claims what would the patient owe for the appendectomy? What would the insurance owe? 2. What does the patient owe for the face lift? 3. What does the patient owe for the preventive colonoscopy? 4. What is the total amount the patient owes?
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