In the BCBS example, what is the amount the payer pays after deductible on the remaining balance?

In the BCBS example, what is the amount the payer pays after deductible on the remaining balance?

• A. $32
• B. $40
• C. $64
• D. $16

Answer: (A)

After the deductible is met, coinsurance splits the remaining allowed charges between the payer and the patient. In the BCBS example, the payer covers 80% of what’s left after the deductible. To find the payer’s amount, multiply the remaining balance by 0.8. If the remaining balance shown in the example is 40, 0.8 × 40 equals 32, so the payer would pay 32. The patient would then be responsible for the other 20% of that remaining balance (which would be 8) plus any deductible already paid.

After the deductible is met, coinsurance splits the remaining allowed charges between the payer and the patient. In the BCBS example, the payer covers 80% of what’s left after the deductible. To find the payer’s amount, multiply the remaining balance by 0.8. If the remaining balance shown in the example is 40, 0.8 × 40 equals 32, so the payer would pay 32. The patient would then be responsible for the other 20% of that remaining balance (which would be 8) plus any deductible already paid.