Calculating Insurance and Discounts

Gaidge Consult manager has two options for calculating contracts amounts with insurance and discounts.

Insurance Benefit applied After Discount

Insurance Benefit applied AFTER discounts(s) are applied, Add-On charges are NOT discounted (and applied AFTER Insurance) In this example:

Discount (20%)             (2840*.20) = 568

Treatment Fee AFTER Discount           2840 – 568 = 2272

Insurance benefit: 50% up to $1500         2272 * .50 = 1136

Insurance Before discount

Insurance Benefit applied BEFORE discounts(s) applied, Discount applied to (Treatment Fee +Add-On charges) less Insurance Amount. In this example:

Insurance benefit: 50% up to $1500            2840*.50 =1420

Discount (20%) -                                              [(2840 + 995) – 1420] * .20

                                                                           2415 * .20 = 483