*Assignment Exercise 133 As a follow-up to the previous Practice Exercise, new assumptions are as follows: 1. Your units gross charges for the period to date amount to $200,000. 2. The uniform gross charge for each procedure in your unit is $100. 3. The unit receives revenue from four major payers. The number of procedures performed for the period totals 2,000. Of that total, the number of procedures per payer (stated as a percentage) is as follows: Payer 1 = 30% Payer 2 = 40% Payer 3 = 20% Payer 4 = 10% 4. The following contractual payment arrangements are in effect for the current period. The percentage of the gross charge that is currently paid by each payer is as follows: Payer 1 = 80% [Medicare] Payer 2 = 70% [Commercial managed care plans] Payer 3 = 50% [Medicaid] Payer 4 = 90% [Self-pay] Q: How many procedures are attributed to each payer? Q: How much is the net revenue per procedure for each payer, and how much is the contractual allowance per procedure for each payer? Q: How much is the total net revenue for each payer, and how much is the total contractual allowance for *Assignment Exercise 134 : Forecast Capacity Levels Review the information in Exhibit 131 below. The exhibit assumes three chairs and one 40-hour RN, for a realistic capacity level of seven patients infused per day. Exhibit 131 Capacity Level Checkpoints for an Outpatient Infusion Center Outpatient Infusion Center Capacity Level Checkpoints # infusion chairs ———————3 chairs # staff ———————1 RN # weekly operating hours ———————40 hours # of hours per patient infusion ————–average 2 hours (for purposes of this example) Work Flow Description For each infusion the nurse must perform the following steps (generalized for this purpose; actual protocol is more specific): 1. Obtain and review the patients chart 2. Obtain and prepare the appropriate drug for infusion 3. Interview the patient 4. Prepare the patient and commence the infusion 5. Monitor and record progress throughout the ongoing infusion 6. Observe the patient upon completion of the infusion 7. Complete charting Work Flow Comments It is impossible for one nurse to start patients infusions in all three chairs simultaneously. Thus the theoretical treatment sequence might be as follows: Assume one half-hour for patient number ones Steps 1 through 4. Once patient number one is at Step 5, the nurse can begin the protocol for patient number two. Assume another one half-hour for patient number twos Steps 1 through 4. Once patient number two is at Step 5, theoretically the nurse can begin the protocol for patient number three. This sequence should work, assuming all factors work smoothly; that is, the appropriate drugs in the proper amounts are at hand, the patients show up on time, and no one patient demands an unusual amount of the nurses attention. (For example, a new patient will require more attention.) Daily Infusion Center Capacity Level Assumption Patient scheduling is never entirely smooth, and patient reactions during infusions are never predictable. Therefore, we realistically assume the following: Chair #1 = 3 patients per day, Chair #2 = 2 patients per day, Chair #3 = 2 patients per day, for a daily total of 7 patients infused. Prepare another Infusion Center Capacity Level Forecast as follows: Assume the same three infusion chairs, but add another nurse for either four or six hours per day. How would this change the daily capacity level for number of patients infused per day? *Assignment Exercise 134 Prepare another Infusion Center Capacity Level Forecast as follows: Increase the number of infusion chairs to four, and add another nurse for either four or six hours per day. How…
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