To determine the patient's balance after both the primary and secondary insurance carriers have made their respective payments, we follow these steps:
### Step 1: Gather Information from the Primary Carrier
- Procedure 99204: The primary carrier has paid [tex]$82.40.
- Procedure 93000: The primary carrier has paid $[/tex]23.20.
### Step 2: Gather Information from the Secondary Carrier
- Procedure 99204:
- Coinsurance/Copay: [tex]$15.00
- Provider Payment: $[/tex]5.60
- Procedure 93000:
- Coinsurance/Copay: [tex]$0.00
- Provider Payment: $[/tex]5.80
### Step 3: Calculate the Remaining Balance for Each Procedure
#### Procedure 99204
1. Primary Carrier Provider Payment: [tex]$82.40
2. Secondary Carrier Coinsurance/Copay: $[/tex]15.00
3. Secondary Carrier Provider Payment: [tex]$5.60
The remaining balance for Procedure 99204 is calculated as:
\[ \text{Primary Carrier Provider Payment} - (\text{Secondary Carrier Coinsurance/Copay} + \text{Secondary Carrier Provider Payment}) \]
\[ 82.40 - (15.00 + 5.60) = 82.40 - 20.60 = 61.80 \]
#### Procedure 93000
1. Primary Carrier Provider Payment: $[/tex]23.20
2. Secondary Carrier Provider Payment: [tex]$5.80
The remaining balance for Procedure 93000 is calculated as:
\[ \text{Primary Carrier Provider Payment} - \text{Secondary Carrier Provider Payment} \]
\[ 23.20 - 5.80 = 17.40 \]
### Step 4: Calculate the Total Remaining Balance
To find the total remaining balance, we sum the remaining balances for both procedures:
\[ \text{Total Remaining Balance} = \text{Remaining Balance for Procedure 99204} + \text{Remaining Balance for Procedure 93000} \]
\[ 61.80 + 17.40 = 79.20 \]
### Conclusion
The patient's remaining balance after the primary and secondary carriers have made their payments is $[/tex]79.20. This is the amount that the patient or another responsible party needs to pay to settle the balance for the services rendered.
