### How JustAnswer Works:

• Ask an Expert
• Get a Professional Answer
• 100% Satisfaction Guarantee

## Ask Mr. Gregory White Your Own Question

Mr. Gregory White, Master's Degree
Category: Multiple Problems
Satisfied Customers: 4494
Experience:  M.A., M.S. Education / Educational Administration
Type Your Multiple Problems Question Here...
Mr. Gregory White is online now

# Baker & Baker Chapters 9-12 Healthcare Finance: HLTH420

### Resolved Question:

Baker & Baker
Chapters 9-12
Healthcare Finance: HLTH420 - 1304A – 01
Unit3 - Individual Project
500-700 words
Your facility has the following payer mix:

40% commercial insurances = 800
25% Medicare insurance = 500
15% Medicaid insurance = 300
15% liability insurance = 300
5% all others including self-pay = 100

Assume that for the time in question you have 2000 cases in the proportions above. (what are the proportions of the total cases for each payer?)
(Calculated above )
The average Medicare rate for each case is \$6200- use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare, Liability insurers average 200% of Medicare and the others average 100% of Medicare rates. (what are the individual reimbursement rates for all 5 payers?)

Calculating Individual Reimbursement Rates for the 5 Payers (Commercial Medicare Medicaid Liability Self pay / Other
Medicare Rate (Baseline) \$6200
Commercial Insurance 110%
Medicaid 65% of Medicare
Liability Insurers 200% of Medicare
Others Average 100% of Medicare Rates
1. What are the expected rates of reimbursement for this time frame for each payer? What is your expected A/R?
2. What rate should you charge for these services (assuming one charge rate for all payers)?(this gives you your total A/R.) Calculate the total charges for all cases based on this rate.
3. What is the difference between the two A/R rates above? Can you collect it from the patient? What happens to the difference?
Rate to be charged for Services \$12,400 *125% Total= \$15,500 2000 *\$15,500= 31,00,000.00You may not collect over R/C contracted fees if you are a Participating Provider. However you would be able to collect on a self-pay patient.Differences would need to be a write-off. Cost Fixed Variable Direct IndirectMaterials/Supplies Variable Direct Wages Fixed Direct Utility/Building Variable Indirect Medications Variable Direct Licensing of Facility Fixed Indirect Insurances Fixed Indirect PerDiem Staff Variable Direct Materials/Supplies \$ 2,270.00 Wages \$ 2,000.00 Utility/Building 1,125.00 Insurances \$ 175.00 TFC/TVC \$2,175.00 \$3,395.00 Contribution Margin \$14,105,XXX-XX-XXXX000 \$5,565,000.00 CM per case (NNN) NNN-NNNN2000 \$2,782.50 BREAK EVEN \$2600000/\$2782.5 934.41 \$150,000 PROFIT 150,000=2782.50V -(NNN) NNN-NNNN P=(V x AR) - TFC V= (NNN) NNN-NNNN The only payers possible to use for an NIC
4. Which of these costs are fixed (does not change z)? Which are variable(changes)? Direct or indirect? Your costs can be either direct or indirect, which is a description of how they are associated with production. (Direct costs are associated with specific units while indirect costs are a lump sum that goes into doing business in general and cannot be easily measured with the production of a specific thing).
o materials/supplies (gowns, drapes, bedsheets) variable indirect
o Wages (nurses, technicians) fixed indirect
o Utility, building, usage exp (lights, heat, technology) fixed indirect
o Medications fixed direct
o
o Licensing of facility fixed indirect
o Per diem staff fixed indirect
o Insurances (malpractice, business etc.) fixed direct
5. Calculate the contribution margin for one case (in \$) with the following costs for this period, per case: a. materials/supplies: \$2270 b. Wages: \$2000 c. Utility, building, usage exp: \$1125 d. Insurances (malpractice, business etc.): \$175
6. Using the above information, determine which is fixed (remains the same ) and which cost is variable (changes). Then calculate the breakeven volume of cases in units for this period.
7. Suppose you want to make \$150,000 profit between this period and next period to fund an expansion to the NICU, how many cases would you have to see? At what payer mix would this
Submitted: 1 month ago.
Category: Multiple Problems
Expert:  replied 1 month ago.
Thanks for using JustAnswer. My name isXXXXX will do whatever I can to answer your questions.

CLICK HERE for the resource on this prompt.

Feel free to request me anytime. Just put "For Mr. Greg" at the front of your post or, even better, bookmark my weblink at www.GregPearl.com and use the question box on my page - still put the "For Mr. Greg Only" in the front of the post so it is directly sent to me.

All the best in your studies and have a wonderful rest of the week.
Mr. Gregory White, Master's Degree
Satisfied Customers: 4494
Experience: M.A., M.S. Education / Educational Administration
Mr. Gregory White and other Multiple Problems Specialists are ready to help you

### JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

### What Customers are Saying:

• Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
< Last | Next >
• Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
• This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
• Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
• I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
• Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
• Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
• He answered my question promptly and gave me accurate, detailed information. If all of your experts are half as good, you have a great thing going here. Diane Dallas, TX

• ### linda_us

#### Satisfied Customers:

1051
Business Analyst and Solution Consultant with over 9 years of experience.
< Last | Next >

### linda_us

#### Satisfied Customers:

1051

Business Analyst and Solution Consultant with over 9 years of experience.

### Mr. Gregory White

#### Satisfied Customers:

775

M.A., M.S. Education / Educational Administration

### FiveStarLaw

#### Satisfied Customers:

565

Lawyer, Accountant and Researcher

### Manal Elkhoshkhany

#### Satisfied Customers:

528

Completed by BA degree in 1988 and graduated with a GPA of 4.0

### F. Naz

#### Satisfied Customers:

384

have completed B.Com and CA Finalist

### Bizhelp

#### Satisfied Customers:

373

BA degree and Certified Public Accountant