Gibson Area Hospital & Health Services (GAHHS) uses the “look-back” method to calculate the “amount generally billed’ (AGB) as required by federal law. The AGB is the maximum amount we will collect from a patient who is eligible for financial assistance under our Financial Assistance policy. The AGB percentage is based on all claims allowed by Medicare and private health insurers over a 12-month period, divided by the associated gross charges for those claims.
For the period of October 1, 2018 through September 30, 2019, GAHHS billed $186,507,158 in gross charges to Medicare and to private health insurers, of which, $81,096,986 in claims were allowed. This makes AGB 43.5%.
Calculation: $81,096,986.00 divided by $186,507,158.00 equals 43.5%.
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