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    Inccured Date Recvd Bill Sent To CHM Provider

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    Jose Castro
    This document contains medical billing and payment information for multiple patients and providers. It includes dates of service, bills received and sent to the Christian Healthcare Ministries (CHM), providers, descriptions of service, whether discounts were applied, the discounted charges, amounts shared by CHM, dates shared and paid, and payment methods. The document shows that CHM helped share costs for a variety of medical services, including prenatal care, lab tests, imaging, and hospitalization, and that discounts from 20-30% were common.

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    Inccured Date Recvd Bill Sent To CHM Provider

    Uploaded by

    Jose Castro
    11 views7 pages
    This document contains medical billing and payment information for multiple patients and providers. It includes dates of service, bills received and sent to the Christian Healthcare Ministries (CHM), providers, descriptions of service, whether discounts were applied, the discounted charges, amounts shared by CHM, dates shared and paid, and payment methods. The document shows that CHM helped share costs for a variety of medical services, including prenatal care, lab tests, imaging, and hospitalization, and that discounts from 20-30% were common.

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    This document contains medical billing and payment information for multiple patients and providers. It includes dates of service, bills received and sent to the Christian Healthcare Ministries (CHM), providers, descriptions of service, whether discounts were applied, the discounted charges, amounts shared by CHM, dates shared and paid, and payment methods. The document shows that CHM helped share costs for a variety of medical services, including prenatal care, lab tests, imaging, and hospitalization, and that discounts from 20-30% were common.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    11 views7 pages

    Inccured Date Recvd Bill Sent To CHM Provider

    Uploaded by

    Jose Castro
    This document contains medical billing and payment information for multiple patients and providers. It includes dates of service, bills received and sent to the Christian Healthcare Ministries (CHM), providers, descriptions of service, whether discounts were applied, the discounted charges, amounts shared by CHM, dates shared and paid, and payment methods. The document shows that CHM helped share costs for a variety of medical services, including prenatal care, lab tests, imaging, and hospitalization, and that discounts from 20-30% were common.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    of 7

    INCCURED DATE RECVD BILL SENT TO CHM PROVIDER

    10/30/2015 11/17/2015 11/20/2015 ABC OBGYN


    11/17/2015 11/17/2015 11/20/2015 ABC OBGYN
    11/17/2015 4/20/2016 4/21/2016 ABC OBGYN
    12/2/2015 4/20/2016 4/21/2016 ABC OBGYN
    12/2/2015 1/15/2016 1/22/2016 ABC Labs
    12/7/2015 12/7/2015 12/13/2015 XYZ Labs
    1/27/2016 1/27/2016 2/12/2016 ABC OBGYN
    2/15/2016 2/15/2016 2/20/2016 XYZ Labs
    6/15/2016 1/22/2016 1/27/2016 ABC Hospital
    6/15/2016 7/7/2016 7/10/2016 ABC Anesthesiology
    DESCRIPTION OF SERVICE BILL SHOWS DISCOUNT? DISCOUNT
    Pregnancy confirmation & pelvic exam Yes 20%
    Self Pay Agreement/Global Fee Yes 20%
    14-week ultrasound Yes 20%
    Pap conveyance Yes 20%
    Pap smear and other testing Yes 10%
    Standard pregnancy blood work Yes 30%
    20-week standard transvaginal ultrasound Yes 20%
    Gestational diabetes 1-hour test Yes 30%
    Prepayment agreement: Normal delivery/48-hr stay No N/A
    Epidural pain relief Yes 25%
    CHARGE w/DISCOUNT AMT SHARED BY CHM DATE SHARED PAID AMT & DATE
    $124.00 $124.00 2/28/2016 $124.00 on 10/30/2015
    $2,240.00 $2,240.00 2/28/2016 $2,240.00 on 12/2/2015
    $200.00 $200.00 6/16/2016 $200.00 on 05/15/2016
    $48.00 $48.00 6/16/2016 $48.00 on 05/15/2016
    $408.60 $408.60 4/27/2016 $408.60 on 01/25/2016
    $555.10 $555.10 2/28/2016 $555.10 on 12/07/2015
    $444.00 $444.00 4/20/2016 $444.00 on 01/27/2016
    $34.30 $34.30 5/21/2016 $34.30 on 02/15/2016
    $2,670.00 $2,670.00 5/4/2016 $2,670.00 on 05/06/2016
    $1,250.00 $1,250.00 9/25/2016 $1,250.00 on 07/21/2016
    PYMT METHOD
    DEBIT CARD
    CREDIT CARD
    PERSONAL CHECK
    PERSONAL CHECK
    DEBIT CARD
    CREDIT CARD
    CREDIT CARD
    DEBIT CARD
    BANK DRAFT
    CREDIT CARD
    INCCURED DATE RECVD BILL SENT TO CHM PROVIDER
    11/17/2015 11/17/2015 11/20/2015 ABC OBGYN
    1/27/2016 1/27/2016 2/12/2016 ABC OBGYN
    6/15/2016 1/22/2016 1/27/2016 ABC Hospital
    DESCRIPTION OF SERVICE BILL SHOWS DISCOUNT? DISCOUNT
    Self Pay Agreement/Global Fee Yes 20%
    20-week standard transvaginal ultrasound Yes 20%
    Prepayment agreement: Normal delivery/48-hr stay No N/A
    CHARGE w/DISCOUNT AMT SHARED BY CHM DATE SHARED PAID AMT & DATE PYMT METHOD
    $2,240.00 $2,240.00 2/28/2016 $2,240.00 on 12/2/2015 CREDIT CARD
    $444.00 $444.00 4/20/2016 $444.00 on 01/27/2016 CREDIT CARD
    $2,670.00 $2,670.00 5/4/2016 $2,670.00 on 05/06/2016 BANK DRAFT

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