Physician office revenue for visit code 99214 has a full established rate of $72.00. Of 10 different payers, there are 9 different contracted rates, as follows:
|Rates for illustration only.|
- 1. Set up a worksheet with four columns: Payer, Full Rate, Contracted Rate, and Contractual Allowance.
- 2. For each payer, enter the full rate and the contracted rate.
- 3. For each payer, compute the contractual allowance.
The first payer has been computed below:
Example 4B: Revenue Sources and Grouping Revenue
Sources of healthcare revenue are often grouped by payer. Thus, services might be grouped as follows:
- Revenue from the Medicare Program (payer = Medicare)
- Revenue from the Medicaid Program (payer = Medicaid)
- Revenue from Blue Cross Blue Shield (payer = Commercial Insurance)
- Revenue from Blue Cross Blue Shield (payer = Managed Care Contract)