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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 April 1, 2014 to March 31, 2015, Lee Health billed $4,871,600,531 in gross charges to Medicare, Medicaid and to private health insurers, of which $1,161,752,205 in claims were allowed. This makes the AGB 23.85%.

Calculation: $1,161,752,205 divided by $4,871,600,531 equals 23.85%

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  • Amount Generally Billed (AGB) Calculation