Outpatient Services
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Total Charges: $300.00 |
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Provider's Interim Rate: 0.40 |
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Part-B Coinsurance Rate: 0.20 |
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Total claim charges (total charges times interim rate, subject to deductible and coinsurance) |
120.00 |
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Part-B deductible (not satisfied prior to this claim) |
- 100.00 |
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Total Part B coinsurance amount |
- 40.00 |
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Medicare Reimbursment |
- 20.00 |
Inpatient PPS Services
(Only full days utilized)
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DRG Reimbursment |
500.00 |
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1999 Part-A cash deductible |
- 768.00 |
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Medicare Reimbursment |
- 268.00 |
Inpatient Non-PPS or SNF Services
|
Four Covered days, no full benefit days left |
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Provider's Per Diem: $80.00 |
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Applicable 1999 coinsurance amount for inpatient day: $192.00 |
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Applicable 1999 coinsurance amount for SNF day: $96.00 |
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Total claim charges for four days |
320.00 |
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Total coinsurance amount for four days |
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Inpatient Non-PPS |
- 768.00 |
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Inpatient SNF |
- 384.00 |
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Medicare Reimbursement |
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Inpatient Non-PPS |
- 448.00 |
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Inpatient SNF |
- 64.00 |