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Concept
Contractual Adjustment
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Summary
A
Contractual Adjustment
is the difference between the
Amount billed by a healthcare provider
and the
Amount agreed upon with an insurance company
, often resulting in a
Lower payment to the provider
. This adjustment is a
Common practice in healthcare billing
and ensures that patients are not charged more than the
Negotiated rate with their insurer
.
Concepts
Healthcare Reimbursement
Insurance Contracting
Billing And Coding
Fee Schedule
Allowed Amount
Patient Responsibility
Provider Network
Claim Adjudication
Negotiated Rates
Managed Care
Legal Modification
Change Of Circumstances
Relevant Degrees
Contract Law 86%
Statute Law 14%
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