Question

Use the following figure to answer this question.

(Excellent Health Plan Member Name:
Veronica Casto
Member ID: MKJ538721P
Prescription Group No: W32187
RX Group: 321543
Generic RX $15
Preferred Name brand RX $50
Nonpreferred Name brand RX $70
Unknown State University
Prime Care Excellence - HMO
Date Issued 04/01/XXXX
In-Network Member Responsibility
Primary $25.00
Specialist $50.00
PT/OT/SP $35.00
BH, SU $100.00
Urgent Care $50.00
ED $150.00)
Veronica had bronchitis for the past eight days. Feeling miserable, she went to the local hospital's Emergency Department for care. She received a prescription for antibiotics. What co-payment should the hospital collect?

Answer 1

The hospital should collect a total co-payment of $165.00 from Veronica, which includes $150.00 for the Emergency Department visit and $15.00 for the generic prescription of antibiotics.

Step-by-step explanation:

Veronica visited the hospital's Emergency Department (ED) for her bronchitis and received a prescription for antibiotics. According to the health plan information provided, the co-payment for an ED visit is $150.00. The co-payment for a prescription, assuming it's a generic antibiotic, would be $15.00. Therefore, the hospital should collect a total co-payment of $165.00 from Veronica for her ED visit and the prescribed antibiotics.