Reimbursement Rate Calculation
Rate of reimbursement %= Reimbursement (payment)/ Fee × 100%
USA Insurance Company
Sims Effie: Rate of Reimbursement= 70/125×100%= 56%
Jones Thomas: Rate of reimbursement= 57/75×100%= 76%
Asberry Alex: Rate of reimbursement= 69/90×100%= 76.67%
Brooks Glen: Rate of reimbursement= 83/128×100%=64.84%
Brown Jameson: Rate of reimbursement=50/85×100%=58.82%
Owens Tommie: Rate of reimbursement=70/100×100%=70%
Presley Elvix: Rate of reimbursement=45/92×100%=48.91%
Switty Conway: Rate of reimbursement=50/88×100%=56.82%
Wilson Kevin: Rate of reimbursement=165/225×100%=73.33%
ABC Insurance
Yeager Rebecca: Rate of reimbursement=90/120×100%=75%
Conway Stephanie: Rate of reimbursement=49/72×100%=68.05%
Lackey Timothy: Rate of reimbursement=64/95×100%=67.37%
Floyd Connie: Rate of reimbursement=76/121×100%=62.81%
Wilson Jackson: Rate of reimbursement=35/80×100%=43.75%
Norton Celia: Rate of reimbursement=90/120×100%=75%
Powers Matthew: Rate of reimbursement=56/98×100%=57.14%
Nelson Carol: Rate of reimbursement=35/78×100%=44.87%
Sanderson Rose: Rate of reimbursement=145/205×100%=70.73%
Best Insurance Agency
Shows Robert: Rate of reimbursement=50/80×100%=62.50%
Jones Teresa: Rate of reimbursement=94/112×100%=83.93%
Trane Caroline: Rate of reimbursement=49/75×100%=65.33%
Nesbitt Richard: Rate of reimbursement=85/130×100%=65.38%
Smith Kyle: Rate of reimbursement=30/65×100%=46.15%
Jacobs Jasmine: Rate of reimbursement=55/100×100%=55%
Trinity Penelope: Rate of reimbursement=25/75×100%=33.33%
New Deloris: Rate of reimbursement=35/78×100%=44.87%
Wilson Brother: Rate of reimbursement=125/195×100%=64.10%
USA Insurance Co, Inc. Radiology Dept
Sims Effie: Rate of reimbursement=90/180×100%=50%
Jones Thomas: Rate of reimbursement=55/100×100%=55%
Asberry Alex: Rate of reimbursement=95/175×100%=54.29%
Brooks Glen: Rate of reimbursement=45/130×100%=34.62%
Brown Jameson: Rate of reimbursement=100/165×100%=60.61%
Owens Tommie: Rate of reimbursement=115/195×100%=58.97%
Presley Elvix: Rate of reimbursement=85/175×100%=48.57%
Switty Conway: Rate of reimbursement=89/218×100%=40.83%
Wilson Kevin: Rate of reimbursement=75/145×100%=51.72%
Patients’ details
|
Patient |
Radiology Dept Fee $ |
Radiology Dept Payment $ |
Radiology Dept Rate of reimbursement % |
Medical Centre Fee $ |
Medical Centre Payment $ |
Medical Centre Rate of reimbursement % |
|
Sims Effie |
$180 |
$90 |
50% |
$125 |
$70 |
56% |
|
Jones Thomas |
100 |
55 |
55 |
75 |
57 |
76 |
|
Asberry Alex |
175 |
95 |
54.29 |
90 |
69 |
76.67 |
|
Brooks Glen |
130 |
45 |
34.62 |
128 |
83 |
64.84 |
|
Brown Jameson |
165 |
100 |
60.61 |
85 |
50 |
58.82 |
|
Owens Tommie |
195 |
115 |
58.97 |
100 |
70 |
70 |
|
Presley Elvix |
175 |
85 |
48.57 |
92 |
45 |
48.91 |
|
Switty Conway |
218 |
89 |
40.83 |
88 |
50 |
56.82 |
|
Wilson Kevin |
145 |
75 |
51.72 |
225 |
165 |
73.33 |
|
Yeager Rebecca |
|
|
|
120 |
90 |
75 |
|
Conway Stephanie |
|
|
|
72 |
49 |
68.05 |
|
Lackey Timothy |
|
|
|
95 |
64 |
67.37 |
|
Floyd Connie |
|
|
|
121 |
76 |
62.81 |
|
Wilson Jackson |
|
|
|
80 |
35 |
43.75 |
|
Norton Celia |
|
|
|
120 |
90 |
75 |
|
Powers Matthew |
|
|
|
98 |
56 |
57.14 |
|
Nelson Carol |
|
|
|
78 |
35 |
44.87 |
|
Sanderson Rose |
|
|
|
205 |
145 |
70.73 |
|
Shows Robert |
|
|
|
80 |
50 |
62.5 |
|
Jones Teresa |
|
|
|
112 |
94 |
83.93 |
|
Trane Caroline |
|
|
|
75 |
49 |
65.33 |
|
Nesbitt Richard |
|
|
|
130 |
85 |
65.38 |
|
Smith Kyle |
|
|
|
65 |
30 |
46.15 |
|
Jacobs Jasmine |
|
|
|
100 |
55 |
55 |
|
Trinity Penelope |
|
|
|
75 |
25 |
33.33 |
|
New Deloris |
|
|
|
78 |
35 |
44.87 |
|
Wilson Brother |
|
|
|
195 |
125 |
64.1 |
Payments by vendors
Looking at the rates of reimbursement for the various vendors, it would be correct to state that Best Insurance Agency had the highest payment rate basing on the patient Jones Teresa who had the highest fee reimbursement rate at 83.93%. For the radiology services, the patient Brown Jameson had the highest rate of reimbursement at 60.61% which was due to USA Insurance Co. Inc.
It is necessary for patients to know the rate of reimbursement offered by their insurance companies as generally these rates are normally pegged on the premiums they pay. The higher the amounts of premiums paid by the insured the higher the rate of reimbursement. The lack of knowledge concerning these rates usually puts clients at a disadvantage in that the insurers can easily exploit them or even manipulate facts to their disadvantage, hence making them to lose out.
A healthcare record can be transformed into coded data by manually extracting the data from the record and then inserting it into an automated tool before they are then analyzed and organized into coded data. Data extraction from health records involves the use of metrics among other options. Coded data is important in such vital areas as pay-for-performance systems and to do with medical centre biosurveillance among other important healthcare infrastructure.
