What is the maximum amount Dr. Brennan can charge Mary Rodgers for treatment under the PFFS plan?

The maximum amount Dr. Brennan can charge Mary Rodgers for treatment under a Private Fee-for-Service (PFFS) plan is determined by the cost-sharing agreements specified in the PFFS plan's terms. PFFS plans are a type of Medicare Advantage plan that provides flexibility in choosing healthcare providers, but they also lay out specific payment structures and cost-sharing arrangements for services.

In a PFFS plan, providers are paid according to the terms defined in the plan, which includes setting limits on how much they can charge beneficiaries like Mary for certain services. These terms ensure that beneficiaries are not charged excessively beyond what the plan allows, providing a level of protection regarding out-of-pocket costs aligned with the plan's parameters.

This structure allows members to have predictable costs for their healthcare services, which is essential for budgeting and financial planning for both the healthcare provider and the patient. Understanding that the plan outlines these cost-sharing mechanisms is crucial in evaluating healthcare expenses within a PFFS framework.