Contractual Adjustment in Medical Billing #healthcare #medicalbilling #ar #claim
#patient
#ushealthcare
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#A Contractual Adjustment is a part of a patient’s bill that a doctor or hospital must write-off (not charge for) because of billing agreements with the insurance company. Adjustments, or write-off’s, are the dollars that are adjusted off a patient account for any reason. The Contractual Adjustment is the most common type of adjustment.
#Just as an insurer and policyholder enter a contract where the insurer promises certain payments in exchange for premiums, the insurer and provider also have a contractual arrangement. When providers agree to accept an insurance plan, the contract will include many details including the amount the insurance company will pay the provider for certain procedures.
The difference between the billing amount and the maximum allowable charge is referred to as a contractual adjustment. The provider cannot charge the patient for the remaining amount given the patient has an agreement with the insurance company.
#PROCEDURE: A contractual adjustment is the amount that the carrier agrees to accept as a participating provider with the insurance carrier. A write off is the amount that cannot be collected from patient due to several issues
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