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    • 10
      May
    • (0)
    • By PeteCrutchley


    • Medical Billing News

    What are the differences between benefits and fees

    The Difference

    This issue came up recently with a consultant surgeon.

    How are fees accounted for against a benefits package?

    Benefits

    Consider the total benefits payable under a patient’s policy. For example, the benefits payable is £100.

    It could be more. The fees mentioned below could be higher too.

    Against such a benefits package, fees are deducted thus:

    Initial: £20.

    The £20 is paid out. The total benefits figure reduces to £80.

    Subsequently, the patient requires surgery. £50.

    This is also paid.

    The accumulator reduces to £30.

    Finally the hospital tenders their account: £20. The gasman submits his: £10. The benefits accumulator, therefore, reduces to ZERO.

    The benefits package is equal to the fees.

    Fees

    However….

    If the initial is £21, the surgery  £51, the hospital  £21, and the gasman £16 then the total fees = £109.  Against a total benefits package of £100.

    Thus, if fees exceed the total benefits a shortfall will be created.

    pete@medicalhealthcaremanagement.co.uk

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