Cleverley, W.O. & Cleverley, J.O. (2018). Essentials of Healthcare Finance (8th ed). Burlington, MA: Jones & Bartlett Learning, LLC
Apa least 300 words. Review the assigned readings and respond to ALL of the following:(In addition to the course textbook, include at lease one other research source.)
1. A non-participating physician provides services to a Medicare patient who has total charges of $100 (before Medicare’s limiting charge is applied). The physician does notaccept assignment, charges the maximum allowable, and submits the claim to Medicare. Assume Medicare’s approved schedule for these services is $80.
- What is the maximum amount the physician is allowed to charge the patient?
- What is the Medicare portion of the physician payment (which Medicare sends to the patient)?
- What is the patient’s portion of the payment to the physician (net of the reimbursement from Medicare in the previous question)?
- Would the physician have been better off by accepting assignment on this case? Why or why not?
2. How do a high percentage of Medicaid (not Medicare) patients influence a hospital’s prices?