HSA 525 Homework

Attention Kim Woods

Assignment Exercise 4–1: Contractual Allowances

Physician office revenue for visit code 99214 has a full established rate of $72.00. Of 10 different payers, there are 9 different contracted rates, as follows:

Payer

Contracted Rate

FHP

$35.70  

HPHP

58.85

MC

54.90

UND

60.40

CCN

70.20

MO

70.75

CGN

10.00

PRU

54.90

PHCS

50.00

ANA

45.00

Rates for illustration only.

Required

  • 1. Set up a worksheet with four columns: Payer, Full Rate, Contracted Rate, and Contractual Allowance.
  • 2. For each payer, enter the full rate and the contracted rate.
  • 3. For each payer, compute the contractual allowance.

The first payer has been computed below:

 

Full

 

Contracted

 

Contractual

Payer

Rate

(less)

Rate

(equals)

Allowance

FHP

$72.00

 

$35.70

 

$36.30

Example 4B: Revenue Sources and Grouping Revenue

Sources of healthcare revenue are often grouped by payer. Thus, services might be grouped as follows:

  • Revenue from the Medicare Program (payer = Medicare)
  • Revenue from the Medicaid Program (payer = Medicaid)
  • Revenue from Blue Cross Blue Shield (payer = Commercial Insurance)
  • or
  • Revenue from Blue Cross Blue Shield (payer = Managed Care Contract)

 

Assignment Exercise 4–2: Revenue Sources and Grouping Revenue

The Metropolis Health System (MHS) has revenue sources from operations, donations, and interest income. The revenue from operations is primarily received for services. MHS groups its revenue first by cost center. Within each cost center the services revenue is then grouped by payer.

Required

  • 1. Set up a worksheet with individual columns across the top for six revenue sources (payers): Medicare, Medicaid, Other Public Programs, Patients, Commercial Insurance, and Managed Care Contracts.
  • 2. Certain situations concerning the Intensive Care Unit and the Laboratory are described below. Set up six vertical line items on your worksheet, numbered 1 through 6. Six situations are described below. For each of the six situations, indicate its number (1 through 6) and enter the appropriate cost center (either Intensive Care Unit or Laboratory). Then place an X in the column(s) that represents the correct revenue source(s) for the item. The six situations are as follows:
    • (1) ICU stay billed to employee’s insurance program.
    • (2) Lab test paid for by an individual.
    • (3) Pathology work performed for the state.
    • (4) ICU stay billed to member’s health plan.
    • (5) ICU stay billed for Medicare beneficiary.
    • (6) Series of allergy tests run for eligible Medicaid beneficiary.
    Headings for your worksheet:

     

    Medicare

    Medicaid

    Other Public Programs

    Patients

    Commercial Insurance

    Managed Care Contracts

    (1)

     

     

     

     

     

     

    (2)

     

     

     

     

     

     

    (3)

     

     

     

     

     

     

    (4)

     

     

     

     

     

     

    (5)

     

     

     

     

     

     

    (6)

     

     

     

     

     

     

CHAPTER 5

Example 5A: Grouping Expenses by Cost Center

Cost centers are one method of grouping expenses. For example, a nursing home may consider the Admitting department as a cost center. In that case the expenses grouped under the Admitting department cost center may include:

  • • Administrative and Clerical Salaries
  • • Admitting Supplies
  • • Dues
  • • Periodicals and Books
  • • Employee Education
  • • Purchased Maintenance

Practice Exercise 5–I: Grouping Expenses by Cost Center

The Metropolis Health System groups expenses for the Intensive Care Unit into its own cost center. Laboratory expenses and Laundry expenses are likewise grouped into their own cost centers.

Required

  • 1. Set up a worksheet with individual columns across the top for the three cost centers: Intensive Care Unit, Laboratory, and Laundry.
  • 2. Indicate the appropriate cost center for each of the following expenses:
    • • Drugs Requisitioned
    • • Pathology Supplies
    • • Detergents and Bleach
    • • Nursing Salaries
    • • Clerical Salaries
    • • Uniforms (for Laundry Aides)
    • • Repairs (parts for microscopes)
    (Hint: One of the expenses will apply to more than one cost center.)

Headings for your worksheet:

Intensive Care Unit      Laboratory      Laundry

Assignment Exercise 5–1: Grouping Expenses by Cost Center

The Metropolis Health System’s Rehabilitation and Wellness Center offers outpatient therapy and return-to-work services plus cardiac and pulmonary rehabilitation to get people back to a normal way of living. The Rehabilitation and Wellness Center expenses include the following:

  • • Nursing Salaries
  • • Physical Therapist Salaries
  • • Occupational Therapist Salaries
  • • Cardiac Rehab Salaries
  • • Pulmonary Rehab Salaries
  • • Patient Education Coordinator Salary
  • • Nursing Supplies
  • • Physical Therapist Supplies
  • • Occupational Therapist Supplies
  • • Cardiac Rehab Supplies
  • • Pulmonary Rehab Supplies
  • • Training Supplies
  • • Clerical Office Supplies
  • • Employee Education

Required

  • 1. Decide how many cost centers should be used for the above expenses at the Rehabilitation and Wellness Center.
  • 2. Set up a worksheet with individual columns across the top for the cost centers you have chosen.
  • 3. For each of the expenses listed above, indicate to which of your cost centers it should be assigned.

Example 5B

Study the chapter text concerning grouping expenses by diagnoses and procedures. Refer to Exhibits 5–3and 5–4(about major diagnostic categories), Exhibit 5–5(about DRGs and MDCs), and Table 5–1(about procedure codes) for examples of different ways to group expenses by diagnoses and procedures.

Assignment Exercise 5–2

Required

Find a listing of expenses by diagnosis or by procedure. The source of the list can be internal (within a healthcare facility of some type) or external (such as a published article, report, or survey). Comment upon whether you believe the expense grouping used is appropriate. Would you have grouped the expenses in another way?

Answers

Related Questions

Other : Exploring The Treadway Commission...

Running Head: EXPLORING THE TREADWAY COMMISSION'S PURPOSEExploring the Treadway Commission's PurposeNameProfessorAuthorInstitutionCourseDate1E...

Writing : R628 Answer...

Theory PresentationNameInstitutional AffiliationDateINTRODUCTION Many theorists have contributed to the development andgrowth of education. These theo...

Business : Small Business Ownership...

Running Head: SMALL BUSINESS OWNERSHIPSMALL BUSINESS OWNERSHIPStudent`s Name:Institutional Affiliation:Date1SMALL BUSINESS OWNERSHIP2Small Business Ow...

Business : Applying Pmbok Concepts To Process Chan...

Applying PMBOK Concepts toProcess Changeby HAL LabSubmission date: 11-May-2019 05:14PM (UT C-0400)Submission ID: 1128882718File name: Applying_PMBOK_C...

Biology : 20190514023321a Sea Circus...

Last Name 1A Sea CircusInstructorClassDateNameA Sea CircusOn August 13, 2018, an Orca whale named J35 dropped her dead calf after carrying itsdeceased...

Science : Bacillus Polymyxa Or Paenibacillus Polym...

1My chosen organism is known as Bacillus polymyxa or Paenibacillus polymyxa. Thisis a bacteria that belongs to the class Bacilli and of the genous Pae...

Management : Mergers And Acquisitions...

Running Head: MERGERS AND ACQUISITIONSMergers and AcquisitionsNameInstitutional AffiliationDate1MERGERS AND ACQUISITIONS2IntroductionTechnology is one...

History : Italian Renaissance 6p...

Running head: ITALIAN RENAISSANCEItalian RenaissanceStudents NameInstitutionInstructorDate1ITALIAN RENAISSANCE2#1). During the fifteenth and sixteenth...

Business Law : B...

Surname 1Name of studentName of tutorCourseDateBusiness Law for Accounts; True or False Questions1. True2. False3. True4. True5. True6. False7. True8....

Business : Evan121.edited...

Running head: CRYSTAL PRODUCTIONS HIRING POLICYCrystal Productions Hiring PolicyStudents NameInstitutional AffiliationDate1CRYSTAL PRODUCTIONS HIRING...

Business : Launching A New Project Vbn...

Running head: LAUNCHING A NEW PROJECTLaunching a New ProjectName of StudentName of Institution1LAUNCHING A NEW PROJECT2Launching a New ProjectMany suc...

Marketing : Chanel Fashion Company...

1Chanel Fashion Company:International Marketing PlanInstitutionInstructorDate2Table of ContentsContents1. Summary .......................................

Geology : Writing Assignment...

Running Head: WRITING ASSIGNMENT #31Writing Assignment #3Authors NameInstitutional AffiliationDateWRITING ASSIGNMENT #32Writing Assignment #3A constan...

Writing : Studio Reflection C...

In this studio practice, I played the role of Cameraman 4 and Teleprompter. It is thefirst time I have been exposed to such work in a studio. When I e...

Other : South Asian American Study...

Running head: SOUTH ASIAN AMERICAN STUDYSouth Asian American StudyName:Course:Professor:Date:1SOUTH ASIAN AMERICAN STUDY2IntroductionUnderstanding the...

Business Law : Net Neutrality...

Running head: NET NEUTRALITY1Net NeutralityNameInstitutionNET NEUTRALITY2Net NeutralityNet Neutrality refers to the aspect that every Internet Service...

Business : Measuring Processes Bnm...

1Running head: MEASURING PROCESSESMeasuring ProcessesStudent's nameStudent's institution2MEASURING PROCESSESMeasuring ProcessesSome few months...

Health & Medical : Alcohol Abuse By Older Women...

Running head: ALCOHOL ABUSE BY OLDER WOMENAlcohol Abuse by Older WomenStudents NameInstitutional Affiliation1ALCOHOL ABUSE BY OLDER WOMEN2Introduction...

Business : Ford 2015 Financial Ratio Analysis.edit...

Running head: FORD MOTORS FINANCIAL RATIO ANALYSISFord Motors Financial Ratio AnalysisNameCourseDate1FORD MOTORS FINANCIAL RATIO ANALYSIS2Ford Motors...

History : R626 History Paper.edited...

Running head: HISTORY PAPER1History PaperInstitution AffiliationDate2HISTORY PAPERIntroductionJohn Quincy Adams United States of America sixth preside...

Management : Ways Of Effective Negotiation...

Running Head: WAYS OF EFFECTIVE NEGOTIATIONWays of Effective NegotiationStudents NameInstitutional Affiliation1WAYS OF EFFECTIVE NEGOTIATION2Ways of E...

Article Writing : Final...

Surname1NameProfessorCourseDateThe Live of Blacks MatterIntroductionIn the article, The Condition of Black Life is One of Mourning by Claudia Rankinei...

Business : 12878066...

Running head: SUPPLY CHAIN AND OPERATIONS PLANNING PROCESSSupply Chain and Operations Planning ProcessStudents NameInstitutional AffiliationDate1SUPPL...

Chemistry : Gas Chromatography...

Running Head: GAS CHROMATOGRAPHYGas ChromatographyStudents NameInstitutional Affiliation1GAS CHROMATOGRAPHY2Gas ChromatographyGas chromatography (GC)...

If you didn't find the right answer

Ask Your Questions, We'll notify you once someone answers it