Community Medical Center's charges, payments, and adjustments from

third-party payers for the month of July are represented in the table below.
a. Calculate the percentage of charges, payments, and adjustments for each
third-party payer and enter the percentages in the correct columns of the
table.

Payer Charges Payments Adjustmen Charges Payment Adjustment

t s s

BC/BS $450,000 $360,000 $90,000  23%  30.5%  11.7%

Commercia $250,000 $200,000 $50,000  12.8%  16.9%  6.49%

l

Medicaid* $350,000 $75,000 $275,000  17.9%  6.35%  35.7%

Medicare $750,000 $495,000 $255,000  38.4%  41.9%  33.1%

TRICARE* $150,000 $50,000 $100,000  7.69%  4.23%  12.9%

Totals $1,950,00 $1,180,00 $770,000 100% 100% 100%

0 0

* Managed care capitated payment for period

 
b. Based on the percentages calculated in the charges column, identify the
payer the facility does the most business with and the payer it does the least
business with. The facility does the most business with Medicare. It does the
least business with TRICARE.
c. Based on the percentages calculated in the payment column, identify the
payers that reimburse the facility the most and the least. BC/BS reimburse
the facility the most, and TRICARE reimburses the facility least.
d. Based on the percentages calculated in the adjustments column, identify
the payers that proportionately reimburse the facility the most and the least.
Medicare reimburses the facility the most, and commercial payers reimburse
the least.