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montant versé versus montant payé

English translation: amount payable vs. amount charged

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21:04 Feb 7, 2012
French to English translations [PRO]
Medical - Insurance
French term or phrase: montant versé versus montant payé
I am translating an insurance statement that lists the "montant payé" and the "montant versé", and montant dépense and montant payé: It looks like this:
montant payé = 90.00 base du remboursement =23.00 taux = 70% montant versé = 16.10

montant dépense = 32. 45 base du remboursement = 32. 45 taux = 65% montant payé = 21.09


Can anyone help clarify this for me? I'm wondering if the first column is the amount paid by the insurance, and the last column the amount paid by the insured? Thanks in advance!
Laura Miller
United States
Local time: 05:08
English translation:amount payable vs. amount charged
Explanation:
Lots of choices for this sort of insurance double talk, but that's how these two terms appear on my Blue Cross/Blue Shield statements:
– amount payable by BC/BS [insurer], and
– amount charged by provider

BTW, I'm assuming the following "formatting":
montant payé = 90.00
base du remboursement = 23.00
taux = 70%
montant versé = 16.10

;-)



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Note added at 18 hrs (2012-02-08 15:04:11 GMT)
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The following PDF contains an explanation as well as a snapshot of a statement that contains the following terms:
– total amount charged
– total amount payable
http://www.roberthowemd.com/patient_education/medicalbills.p...

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Note added at 19 hrs (2012-02-08 16:07:41 GMT)
--------------------------------------------------

Here are the explanations of the two terms, as found on the "RobertHoweMD" link:

Total Amount Charged – The amount the Provider charged the insurance company for the service.
Total [Amount] Payable – The amount the insurance company has agreed to pay the Provider. It should equal the Providers’ Charges minus any Negotiated Savings and Deductible, Co-payment and Coinsurance amounts.


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Note added at 20 hrs (2012-02-08 17:30:43 GMT)
--------------------------------------------------

RE: do you think they would apply to the French healthcare/insurance system?
It seems to be borne out by the numbers you supplied, don't you think? :-|
In any case, you might be able to figure that out from the materials in your hand. Insurance statements usually contain lots of definitions, though usually in fine print. ;-)
Selected response from:

cc in nyc
Local time: 05:08
Grading comment
Thank you so much for your help!
4 KudoZ points were awarded for this answer

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Summary of answers provided
4amount payable vs. amount chargedcc in nyc
4Amount reimbursed versus amount paidColin Morley


Discussion entries: 10





  

Answers


1 hr   confidence: Answerer confidence 4/5Answerer confidence 4/5
Amount reimbursed versus amount paid


Explanation:
'Versement' is a payment so this is not strictly literal of course, but in your example, the sum of 23 Euros (normal doctor's fee) is reimbursed at 70% by National Insurance - see my discussion note. It can get very complicated with different rates of reimbursement for different people and different treatments. By way of a bit of an explanation, see link below


    Reference: http://www.connexionfrance.com/why-do-we-pay-for-healthcare-...
Colin Morley
France
Local time: 11:08
Native speaker of: English
PRO pts in category: 8
Notes to answerer
Asker: OK, that makes sense, and thanks for the helpful link!

Asker: OK, so, let me see if I have this straight: The 23.00 is reimbursed at 70% by National Insurance, which means that the insurance will pay 16.10. But what is the 90.00??

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7 hrs   confidence: Answerer confidence 4/5Answerer confidence 4/5
amount payable vs. amount charged


Explanation:
Lots of choices for this sort of insurance double talk, but that's how these two terms appear on my Blue Cross/Blue Shield statements:
– amount payable by BC/BS [insurer], and
– amount charged by provider

BTW, I'm assuming the following "formatting":
montant payé = 90.00
base du remboursement = 23.00
taux = 70%
montant versé = 16.10

;-)



--------------------------------------------------
Note added at 18 hrs (2012-02-08 15:04:11 GMT)
--------------------------------------------------

The following PDF contains an explanation as well as a snapshot of a statement that contains the following terms:
– total amount charged
– total amount payable
http://www.roberthowemd.com/patient_education/medicalbills.p...

--------------------------------------------------
Note added at 19 hrs (2012-02-08 16:07:41 GMT)
--------------------------------------------------

Here are the explanations of the two terms, as found on the "RobertHoweMD" link:

Total Amount Charged – The amount the Provider charged the insurance company for the service.
Total [Amount] Payable – The amount the insurance company has agreed to pay the Provider. It should equal the Providers’ Charges minus any Negotiated Savings and Deductible, Co-payment and Coinsurance amounts.


--------------------------------------------------
Note added at 20 hrs (2012-02-08 17:30:43 GMT)
--------------------------------------------------

RE: do you think they would apply to the French healthcare/insurance system?
It seems to be borne out by the numbers you supplied, don't you think? :-|
In any case, you might be able to figure that out from the materials in your hand. Insurance statements usually contain lots of definitions, though usually in fine print. ;-)


cc in nyc
Local time: 05:08
Native speaker of: English
PRO pts in category: 26
Grading comment
Thank you so much for your help!
Notes to answerer
Asker: Thanks for your answer and your references, but do you think they would apply to the French healthcare/insurance system?

Asker: Not in this case, there are no definitions in fine print, and the fax quality is really poor as well, making it even more fun. I translate invoices from France and other French-speaking countries on a regular basis, and have yet to come across this sort of thing. I'll figure it out eventually, thanks for your help!

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