An explanation of benefits states the amount billed was $80, the allowed amount is $60, and the patient is required to pay a $20 copayment. Which of the following describes the insurance check amount to be posted?

Prepare for the NHA Billing and Coding Specialist exam. Study effectively with flashcards and multiple-choice questions offering explanations and hints. Ensure you're ready for success!

In this scenario, the amount billed is $80, but the allowed amount by the insurance is only $60. The patient is responsible for a $20 copayment, which is part of their cost-sharing for the service received.

To determine the insurance check amount that would be posted, you start with the allowed amount of $60. From this, the copayment of $20 is deducted, as this amount is not covered by insurance but is paid by the patient.

Therefore, the insurance check amount can be calculated as follows:

Allowed amount: $60

Patient copayment: $20

Insurance's responsibility: $60 (allowed amount) - $20 (copayment) = $40

This means that the insurance will issue a check for $40, which is the amount they are required to pay after accounting for the patient's copayment. Thus, the correct answer indicates the insurance check amount that will be posted is $40.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy