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How to Calculate Patient and Payer Responsibility (Copay vs Coinsurance vs Deductible)

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Description How to Calculate Patient and Payer Responsibility (Copay vs Coinsurance vs Deductible)

Comments How to Calculate Patient and Payer Responsibility (Copay vs Coinsurance vs Deductible)

This helped me a lot I just started a medical billing and coding course This explained everything about calculations of copays, coinsurance, and deductibles Thank you for this!! Comment from : @tracygideon3469

I appreciate this video so much I was stuck on an assignment, but this video walked me through it step by step, which gave me confidence that I can continue on with my class Comment from : @karlabaxter5077

Literally helpful Really learn to differentiate b/w copay & co-insurance , deductible & oop Comment from : @anisanwar7553

Thank you so much I understood everything!!! Comment from : @nikkihunter-vf1uh

Thank you!❤ Comment from : @MaxHealthcareBilling

very well explained! thank you! Comment from : @Atlas_shrugged123

Thank you so much you made this easy for me to understand Comment from : @ashleypostel3652

Question: for example 5, why did they add the unmet deductible back to the patience responsibility, but didn’t do the same for example 3? Comment from : @thebudgetaffair5028

❤ Comment from : @MaxHealthcareBilling

I have replayed this like ten times Already thank you Comment from : @rickypineda2053

Hi, how can I join the webinar? Comment from : @BeverlySumando-j7j

Simply superbget going Comment from : @sushobhanroy3623

Is it same with dental billing? Comment from : @Zainab-mfc

Your presentation was beneficial Thank you Comment from : @merletrimble3607

Great examples and easy to comprehend Thank You ! Comment from : @natalieferns6770

Great video , very informativebrCan you explain about the adjustment amountbrHow is that amount met?brbrThanks in advance ma'am Comment from : @GopzMenon

I’m interested Comment from : @margierodriguez7146

great!! Comment from : @bushratarif6028

Thanks a lot for this informative video ❤😊brIs the adjustment amount also added to patient responsibility?brbrThanks in advance Comment from : @gopikabmenon7905

Love how you broke it down!!!! Comment from : @ladijane081

I wish I had seen this before my exam Thank you! Comment from : @janicebarth9121

If a patient has a $1750 deductible with primary insurance Our allowable is $1250 None of the Deductible has been met They also have a secondary insurance that just happens to be Medicare Our allowed amount with them is $110854 How do I figure out how much the patient will owe? Comment from : @tenacalloway7998

This video is worth a million lol 😂 I love how you did this, I just started a new billing job and I have to explain bills and eobs to patients This is perfect Thanks so much you are awesome and I hope to take your course once I finish my CPC certification Thanks so much 😊 Comment from : @IamShanRich

thank you for this break down Comment from : @NeneLane

THANK YOU! <3 Comment from : @seraxmae

Why they adulterated the amount???? Comment from : @Gamingforfun78

Do business owners who want to offer health benefits need to learn this information as well? Comment from : @codewithsharen1404

What is the ADJUSTMENT for? Comment from : @jasmenluna2041

the amount of synapses occurring in my brain is so strong that the earth may reverse its rotation, i swear thank you so much, Quiana Comment from : @rackyshak

Hi Quiana! I really love how you explain each terms and gave different examples for each scenarios May I kindly ask what is the adjustment for? and for example number 1, what the total amount of the patient is responsible to pay? is it 80? since copay is not covered by the insurance plus the 40 patient responsibility? brbrThank so much in advance as this would help me to become an effective HR and I am new with the US health insurance <3 Comment from : @sofiamendoza683

Good morning,I was interested in joining your on-line refresher insurance class I have been in the medical field for many years and have recently changed positions In my new position I will be required to verify patients' benefits and what their cost will be for services I found your video extremely helpful You mentioned you have a 6 week refresher course held  every Wednesday I am interested if you still offer this classThank you for your time brNancy Etter Comment from : @NancyEtter-y7t

Thank you very much for a very informative and easy-to-understand computation for patient and payer responsibility Comment from : @eubheabenio7357

The fact that I’m watching this Aug 13th, ‘24 and slide #5 is dated Aug 13, 2021… mad wild! 😮 Comment from : @kgee1576

Wow! This was a Godsend I am taking my exam in one hour I have been in a billing/coding course for a year Calculating patient responsibility did not make sense this whole time until I watched your video I wish I found you sooner Would have taken your zoom course Thank you immensely! I wish I could hug you :) Comment from : @beckybennett2538

Ohhhhhhhhhh 💡thank you!!!! Comment from : @PettyTenderass

Excellent explanation Each examples are fantastic 🎉❤ Comment from : @roy_abir33

If patient has a deductible and also a coinsurance, they’re deductible has to first be met before the coinsurance metric kicks in correct? - love your videos btw Comment from : @TheRealWildCarl

All I can say is thank you for breaking this down for me You were extremely helpful Comment from : @LaShander

Your breakdown of the billing process was so helpful, thank you! Comment from : @LaTonyaBrewer

So detailed Would like to take classes Comment from : @christinehichez4159

Just came across your channel today You are a good teacher I will be watching more of your videos Comment from : @darlenedunbar6160

Thank you life saver! I understand it way better now! Comment from : @echomercilesssamoah

Hi can you explain how the Billed amount is calculated and what you mean by the amount that is “written off” is there any tax ramifications or is it just a “discount” for the services being in network? Comment from : @meganj5485

Very nice explanation 🎊 Comment from : @starvijay7689

I'm going to school for medical records specialist but I'm having a very hard time doing deductibles and co-pays and all of that adding them just like you showing your video which was very helpful do you have more examples and more of a breakdown on how to do that Comment from : @alisa-franco

So i am reading over my CPC study guide I don’t understand the RBRVS, work RVU scale thing Is knowing how to calculate facility or non facility pricing amounts more of a coding thing or billing thing? Comment from : @robinson2589

How can you tell if there is a contractual adjustment? All the fields that the EOB I'm looking at provides is: Fee charged, PDP (if applicable), covered expense, benefit paid If there is something in the PDP fee column does that indicate a contractual adjustment? Comment from : @crystalgoudie

I’m soooo glad I found your channel!!! A Godsend!!! Thank you so much!!! 🫶🏾🫶🏾🫶🏾🙌🏾🙌🏾🙌🏾 Comment from : @ash_boo12

How i can get job in ar caller Comment from : @rudGaming-xp3tj

Thank you for explanation, a QUESTION Does your deductible meet by service date or by claim date? I have Aetna, and could not find any info (standard saving) Comment from : @annaperezlara91

In your example 5, Is it possible that the remaining unmet deductibles are gradually deducted from the patients instead of full amount on the treatment from the patient Comment from : @asadmian2274

What is the Allowed amount mean????? How does that amount come about? Comment from : @yolandaarocha6067

Thank you! Are you still doing the courses via Zoom? Comment from : @kaykay1974

How does copay works when there is a secondary insurance? Comment from : @janleoung7237

I want to work as a Medical biller how can you help if you would like to outsource I can work for you Comment from : @waleedbaig2701

Thank you! Comment from : @princessbejai3276

Hi mam good evening,I am Lakshmi from tamil nadu,i have 3years experience in medical billing trainer any job vacancy from your side mam Comment from : @LakshmiIHCBPO

Just one question So who pays the adjustments amount? Is it the patient? Comment from : @animeshmohanty7855

This was very helpful, can you explain what happens to adjustment? Comment from : @shwetainamdar6326

What is your IG account?☺️ Comment from : @bernardlacro32

I am so glad that people like you are able to make videos helping out students, this really helped me understand most of the medical billing part of the Health Insurance and Medical Billing tests in BPA Hopefully my results improve for state BPA Comment from : @magellanmando615

Hello, I am still confused about how to calculate the write off amount Is there a specific formula that I need to use to calculate or determine it In what ways there is no write off amount? Comment from : @beautybrainsbrawn

Hi Quiana I am really new to insurance and medical billing In your example 4, why is that the patient responsibility is 0USD and what does remainder of their benefit year means? And does the adjustment is the amount the patient is going to pay? Thanks a lot and it will be a big help for me Comment from : @capricornium2033

This was so helpful! Thank you Comment from : @desireeeverett3517

Deductible calculations for sugery Comment from : @christinehichez4159

thank you so much for this infomation!!!!! Comment from : @JodiJuenger-h6t

You are an amazing teacher!! Thank you so much, Quiana! :) Comment from : @JeanetteHays-g1c

This really clarified things for me (I'm an NP) Let's say a patient's primary insurance is Medicare bur they have a secondary insurance, eg, a Medicare supplement plan I am an in-network Medicare provider but not in-network for their supplement Do I do the calculations described in the video using Medicare numbers? brWill you eventually do a video about not in-network provider calculations?brThanks so much!brVery best,brAbby Stuthers, NP Comment from : @abbystuthers4338

What is allowed amount? Comment from : @IrfanPasha-nd9nx

thank you!! this is so helpful <3 Comment from : @avegailcastanetas1507

Hi what happen after deductible met whether the insurance pay total bill after deductible met it's correct please reply Comment from : @DAASAREESHREEDHARH

Example 5 was excellent for my education on how to read my EOB! Thank you very much!!! Comment from : @toddyrich118

How do you find out what the allowed amount is? Comment from : @thebeautybanga

Amazing 🤩 explanations Comment from : @thebeautybanga

Very good informative video 👍 Comment from : @mafullgaming

Can you enlighten me with this one? brbrThis is an example from our training Heres the only information provided including the questions Thank you so much in advance brbrScenario: Mark has an insurance policy with 100 Usd monthly premium , a 1000 USD deductible and a 5000 USD out of pocket maxim He broked his leg and got a hospital bill of 10000 usd , how much of this bill he has to pay? brbrHow much is total expenses of mark considering his deductibles and out of pocket? brbrHow much of total expenses will be covered by the insurer? Comment from : @kennethroxas2984

WOW I understand that awesome THANK YOU Comment from : @keyshianorman6

Hi Comment from : @Pussyboi4

So helpful! Thank you! Comment from : @julierodriguez7140

Hello I am currently in the Medical Billing part of my online Medical Coding Course Learning who pays first when multiple agencies invilved Trying to understand why all don't charge the same and pay the same Comment from : @bernfran1313

This is a great video It just leaves one question what happens to the adjustment amount? Does the patient has to pay this as I assume it was billed to the patient and the insurance reimburses only the of the allowed amount? Thank you for your advice Comment from : @andreabruns8939

Interesting Comment from : @bernfran1313

You are doing the lord’s work, this is the first time it had made sense, big THANK YOU!!! ❤ Comment from : @meowser7

Hii Qiana i want to work in USA as a biller I'm working in India as a biller m a senior Account receivable i am 23 and i know about the denials RCM i worked in some software's can u help me to know how do join or work in USA as a biller Comment from : @sandeepjaiswar690

Example 4 is this a scenario when a patient don’t have an ded but have an OOP with a coinsurance? Comment from : @wrightnyree8215

So example 3 the adjustment is $260 this giving be written off? brBecause the patient is only responsible for paying the $330 allowed amount due to not met their ded? Comment from : @wrightnyree8215

Why is insurance reimbursement have less amount,, and patient responsible have more amount Comment from : @ShaikIbrahim-nt5rm

thank you thank you thank you! I'm currently taking an online medical billing/coder class and I was super lost! I can tell you love what you do and this gives me inspiration to keep going and not give up on this class Comment from : @tinagraham1386

Plz more sample so if they have a 2000 deductible in network and have a copay of 25 dollar they pay 25 everytime they come in correct Comment from : @ivettereyes6646

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