Your facility has the following payer mix:
40% commercial insurances25% Medicare insurance15% Medicaid insurance15% liability insurance5% all others including self-pay
Write a 3-4 page report that addresses the following requirements:
Assume that for the time in question you have 2000 cases in the proportions above. (What are the proportions of the total cases for each payer?) The average Medicare rate for each case is $6200- use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare, Liability insurers average 200% of Medicare and the others average 100% of Medicare rates. (What are the individual reimbursement rates for all 5 payers?)
What are the expected rates of reimbursement for this time frame for each payer? What is your expected A/R?
What rate should you charge for these services (assuming one charge rate for all payers)? (This gives you your total A/R.) Calculate the total charges for all cases based on this rate.
What is the difference between the two A/R rates above? Can you collect it from the patient? What happens to the difference?
Which of these costs are fixed? Which are variable? Direct or indirect?
materials/supplies (gowns, drapes, bedsheets)
Wages (nurses, technicians)
Utility, building, usage exp (lights, heat, technology)
Licensing of facility
Per diem staff
Insurances (malpractice, business etc.)
Calculate the contribution margin for one case (in $) with the following costs for this period, per case: a. materials/supplies: $2270 b. Wages: $2000 c. Utility, building, usage exp: $1125 d. Insurances (malpractice, business etc.): $175
Using the above information, determine which is fixed and which cost is variable. Then calculate the breakeven volume of cases in units for this period.
Suppose you want to make $150,000 profit between this period and next period to fund an expansion to the NICU, how many cases would you have to see? At what payer mix would this be optimal?
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.Read more
Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.Read more
Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.Read more
Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.Read more
By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.Read more