Under an 80/20 plan, if a participating provider's usual charge is $200 for a procedure and the allowed amount is $150, the provider can collect:
$150 from the insurance carrier and $50 from the patient.
$120 from the insurance carrier and $30 from the patient.
$120 from the insurance carrier and $80 from the patient.
$160 from the insurance carrier and $40 from the patient.
Answer: $120 from the insurance carrier and $30 from the patient.
Health Professions
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