Health Finance

The Metropolis Health System (MHS) has revenue sources from operations, donations, and interest income. The revenue from operations is primarily received for services. MHS groups its revenue first by cost center. Within each cost center the services revenue is then grouped by payer.

Required
  1. Set up a worksheet with individual columns across the top for six revenue sources (payers): Medicare, Medicaid, Other Public Programs, Patients, Commercial Insurance, and Managed Care Contracts.
  2. Certain situations concerning the Intensive Care Unit and the Laboratory are described below.

Set up six vertical line items on your worksheet, numbered 1 through 6. Six situations are described below. For each of the six situations, indicate its number (1 through 6) and enter the appropriate cost center (either Intensive Care Unit or Laboratory). Then place an X in the column(s) that represents the correct revenue source(s) for the item. The six situations are as follows:

  1. ICU stay billed to employee’s insurance program.
  2. Lab test paid for by an individual.
  3. Pathology work performed for the state.
  4. ICU stay billed to member’s health plan.
  5. ICU stay billed for Medicare beneficiary.
  6. Series of allergy tests run for eligible Medicaid beneficiary.

Hint 1: If you are an employee then you are working, therefore you are assumed to have coverage from your employer.

Hint 2: “Work performed for the state” is not put through Medicare or Medicaid.

Sheet1

GHA 2 Template
INDICATE ANSWER WITH AN “X”
INDICATE ICU or LABMEDICAREMEDICAIDOTHER PUBLIC PROGRAMSPATIENTSCOMMERCIAL INSURANCEMANAGED CARE CONTRACTS
ICU stay billed to employee’s insurance company
Lab test paid by an individual
Pathology work performed for the state
ICU stay billed to member’s health plan
ICU stay billed for Medicare beneficiary
Series of allerfy tests run for eligible Medicaid beneficiary