Question

Mike moroni is covered by a member health plan with a 20% discount from the provider usual fees and a $20.00 copay. the charges are 365.50. what amount will the hmo pay? what does the patient owe?

Answer 1

To calculate the healthcare costs for Mike Moroni, a 20% discount and a $20 copay are applied to the total charges. The HMO pays $272.40, and Mike Moroni owes $93.10 in total.

Step-by-step explanation:

The question concerns the calculation of healthcare costs for Mike Moroni who is covered by a member health plan with a 20% discount from provider fees and a $20.00 copay. The provider's charge for services rendered to Mike Moroni is $365.50. To determine what amount will be paid by the health maintenance organization (HMO) and what the patient owes, we apply the plan's terms to the charges.

The steps are as follows:

1. Calculate the discount: 20% of $365.50 is $73.10.
2. Subtract the discount from the total charge: $365.50 - $73.10 = $292.40.
3. Subtract the copay amount that the patient is responsible for: $292.40 - $20.00 = $272.40.

Thus, the HMO will pay $272.40, and including the copay, Mike Moroni will owe a total of $93.10 ($73.10 discount + $20.00 copay).