Amber case: With Allowed $1,300; Paid $1,250; patient responsibility $50; contract expected amount $1,400. What is the contractual variance?

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Multiple Choice

Amber case: With Allowed $1,300; Paid $1,250; patient responsibility $50; contract expected amount $1,400. What is the contractual variance?

Explanation:
Contractual variance is the difference between what the contract says should be paid (contracted amount) and what is actually allowed by the payer. In this case, the contract expects 1,400, but the plan allowed 1,300. The difference is 1,400 minus 1,300, which equals 100. So the contractual variance is 100. The fact that the patient pays 50 and the plan actually pays 1,250 is just how the 1,300 allowed is split; it doesn’t change the contract-level variance.

Contractual variance is the difference between what the contract says should be paid (contracted amount) and what is actually allowed by the payer. In this case, the contract expects 1,400, but the plan allowed 1,300. The difference is 1,400 minus 1,300, which equals 100. So the contractual variance is 100. The fact that the patient pays 50 and the plan actually pays 1,250 is just how the 1,300 allowed is split; it doesn’t change the contract-level variance.

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