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Amount Generally Billed (AGB) Calculation

Lee Health 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 OCT 1 2019 TO SEPT 30, 2020, Lee Health billed $7,078,230,010 in gross charges to Medicare, Medicaid and to private health insurers, of which $1,645,945,388 in claims were allowed. This makes the AGB 23.25%.

Calculation: $1,645,945,388 divided by $7,078,230,010 equals 23.25%

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  • Amount Generally Billed (AGB) Calculation