Question

After a healthcare provider has performed, coded, and billed an insurance company for procedures, the provider expects to receive an_________ to pay for some or all of the costs of the performed procedure.

Answer 1

Contractual Adjustment is a part of the agreement in which the hospital has agreed to not charge any expenses because of the terms of the insurance company.

What is Contractual Adjustemement or Adjustment?

• Contractual adjustment is defined as the part of a patient's bill that should not be charged because of the billing agreements with the insurance company.

• The adjustment is also referred to as write-offs, in which the amount in the patient's bill is automatically adjusted in the cost of the procedure.

Thus, the provider expects to get a write-off or an adjustment based on the billing agreements of the insurance company.

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