Use the fоllоwing infоrmаtion for questions 23 through 25. On Jаnuаry 1, General Hospital entered into a capitated contract with ABC Health Plans to provide healthcare services to 200,000 of ABC's covered lives. The contract is a global risk contract, and does not contain any risk sharing provisions. In researching General's historical lag between when claims occur and when they are paid, you obtain the following information: Claims paid in the month they are incurred: 15% Claims paid in the month after they are incurred: 50% Claims paid two months after they are incurred: 25% Claims paid three months after they are incurred: 10% You determine that the medical claims expense recorded for the months of March, April and May were $30 million, $27 million and $21 million, respectively. During the month of June, General paid $25 million of medical claims, of which $3 million were for services rendered in June. You also learn that General received but has not yet paid invoices from healthcare providers for services rendered to lives covered under General’s global risk contract; the invoices total $5 million of which $2 million relate to services rendered in June. What is the amount of RBUCs that General should have on its books at June 30?
Use the fоllоwing infоrmаtion for questions 26 through 28. Mrs. Jones hаs heаlth insurance provided by her employer. Her coverage is a high deductible health plan offered by Blue Cross Blue Shield (BCBS); the amount of her deductible is $5,000. Assume she has no co-pay. Mrs. Jones had emergency surgery at Pima Community Hospital (PCH), and her charges totaled $59,000. BCBS has negotiated discounted rates with PCH; for the surgery Mrs. Jones had, the negotiated reimbursement is $30,000. PCH bills BCBS $25,000, and bills Mrs. Jones $5,000. What is the amount of net patient service revenue that PCH should record in its financial statements related to Mrs. Jones’ surgery if Mrs. Jones has the financial resources to pay her bill and has previously paid her PCH bills?