Learning Unit 1 Applying Your Knowledge

Case 1.1 Abstracting Insurance Information

A. $10
B. $250 Ded 80%/20%
C. The patient must have approval in advance before being admitted, and the approval has to
be obtained at least seven days before the scheduled visit and within forty-eight hours of
admission in an emergency case or the next business day after a holiday or weekend
emergency admission.
Case 1.2 Calculating Insurance Math
A. $95
B. $750 ins $250 patient
C. $336 ins $84 patient
D. $0
E. $229.50
F. $1055.60
G. Since the cost of surgery is $1890 which is less than the remaining deductible amount of
$2200, no amount can be collected from a co-payer until an additional $310 is paid, then
the full deductible amount will have been met. ($2500-$300=$2200, $2200-$1890=$310)
($300+$1890+$310=$2500
H. $2400 ins $1600 patient
Case 1.3 Using Insurance Terms
A. PPO
B. $5659.92
C. $2500
D. 0%
E. $6000