Explain potential reasons for budget variances.

Learning Goal: I’m working on a health & medical exercise and need an explanation and answer to help me learn.HIMA240 Healthcare Reimbursement MethodologiesAssignment: Commercial Insurance Reimbursement and CapitationYou have been hired as the billing manager for Nash Medical Center and Clinics. One of your responsibilities is to calculate what the patient owes and what the insurance company owes, so that you can determine what revenue to expect for these services. You have the charge and the usual, customary, and reasonable (UCR) amount. The reimbursement will be calculated on the 80/20 distribution. The deductibles for each of these patients have been met. Under this insurance plan, $20.00 copays are due for primary care physician office visits and $40.00 copays for specialists. There is no copay for other services.The Medical Center also recently negotiated with a group of employers to treat their patients based on a capitated amount of $750 per person per month (pmpm) This group of employers has combined 6,525 employees. You predict that your cost will be $610 per month per person.The budgeted revenue was initially $1,575,000.You were provided with the following report.ServiceChargeUCRPatient’s CopayPatient’s CoinsuranceInsurance PaysPatient OweInternal medicine$120.00$120.00Physical therapy$150.00$97.00X-ray$115.00$73.00MRI$1,845.00$147.00Specialty visit$165.00$90.00Specialty visit$75.00$70.00Lab test$32.00$19.00Lab test$45.00$29.00Mammogram$151.00$95.00Instructions for this assignment:Part I: Determine the patient’s responsibility by completing the chart.Using the reimbursement information, calculate:Patients Copay amount (if applicable)
Coinsurance
Amount insurance will pay
How much the patient owes
Part II: Based on the negotiated capitation (pmpm) amount, predict:Expected revenue and total profit per month
Expected revenue and total profit per year
An executive summary is a document or proposal that provides a brief overview or summary. In this case, it is used to summarize the findings of your report. In a 1-2 page executive summary:Calculate the reimbursement amount for each service.
Calculate expected revenue and total profit per month and per year.Summarize your reimbursement data
Summarize your prediction and forecasting data.Compare to the budgeted revenue.
Explain potential reasons for budget variances.
Submit your executive summary and calculations.Grading CriteriaPointsProvide reimbursement calculations.15 pointsCalculate expected revenue per month and per year.15 pointsSummarize reimbursement data.20 pointsSummarize expected revenue and profits prediction and forecasting data.20 pointsCompare the budgeted revenue and explain reasons for potential budget variances.20 pointsWriting and organization10 pointsTotal Points100 points
Requirements: Assignment answers   |   .doc file

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

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.

Money-back guarantee

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

Zero-plagiarism guarantee

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

Free-revision policy

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

Privacy policy

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

Fair-cooperation guarantee

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