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Key Explanation

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Original Question

For this case study the RA information is more limited. The details of the procedure are not given. Based on the information provided, however, you should still be able to calculate the patient’s balance. Note that the claim for this case was originally created in Case Studies 15.11 through 15.20. Case Study 16.21 Patient: Karen Giroux Primary payer Anthem BCBS Traditional (80-20 coinsurance; $250 deduct.) Charge amount $180.00 Allowed amount $180.00 Deductible due $ 0.00 Coinsurance $ 36.00 Payment to provider $144.00 Secondary payer Anthem BCBS PPO Payment to provider $ 28.80 (80% of coinsurance) Patient balance:

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