A nonparticipating provider in TRICARE sees a patient and provides a service with an allowed charge of $200. However, the provider charges the patient $250 for the service. Determine what amount the patient must pay.

Question

Quizplus · Accepted Answer

Nonparticipating providers in TRICARE can charge up to 15% over the TRICARE-allowed amount for services. Therefore, for a service with an allowed charge of $200, the provider can charge up to $230 ($200 + 15% of $200).

A Nonparticipating Provider in TRICARE Sees a Patient and Provides