How To Calculate PAR Reimbursement - Definition, Formula, Example

How To Calculate PAR Reimbursement - Tutorial

Definition:

PAR (Participating Providers) is a simple agreement with medicare that the amount spent on medical charges can get reimbursement. This reimbursement is calculated on some rules, If the person is participating providers. Then the 80% from the allowable amount will be returned in that patient should pay 20% co-payment of the bill.

Formula:
Total reimbursement = (allowable amount x 80%) - patient 20% co-pay
Example :

Calculate the total reimbursement for the participating provider when the allowed payment is Rs.5000.

To Find,

Total reimbursement

Solution:
Total reimbursement = (allowable amount x 80%) - patient 20% co-pay
= (5000 x 0.8) - (5000 x 0.2)
= 4000 - 1000
= 3000

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