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12 September, 14:32

Stephanie was injured in a car accident was rushed to the emergency room. She received stitches for a facial wound and treatment for a broken finger. Under Stephanie's PPO plan, emergency room care at a network hospital is 80 percent covered after the member has met a $300 annual deductible. Assume that Stephanie went to a hospital within her PPO network. Her total emergency room bill was $850. What amount did Stephanie have to pay? What amount did the PPO cover?

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Answers (2)
  1. 12 September, 15:37
    0
    60/40
  2. 12 September, 16:26
    0
    Hence,

    the amount paid by the Stephanie = $410

    The amount covered by PPO = $440

    Explanation:

    Given:

    Percent covered by the insurance = 80%

    Annual deductible = $300

    Total emergency room bill = $850

    Now,

    The Coinsurance expenses = Total expenses - Annual deductible

    or

    The Coinsurance expenses = $850 - $300 = $550

    The amount covered by PPO

    = Percent covered * Coinsurance expenses

    = 0.80 * $550 = $440

    Therefore,

    the amount paid by the Stephanie

    = Annual deductible + (Coinsurance expenses - amount covered by PPO)

    = $300 + $550 - $440 = $410

    Hence,

    the amount paid by the Stephanie = $410

    The amount covered by PPO = $440
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