A provider's standard fee for a service is $150. The patient's insurance plan has a contracted rate of $120 for that service. What is the $30 difference between these two amounts called when posting payments and adjustments to the patient's account?
The $30 difference between the provider's standard fee ($150) and the insurance's contracted rate ($120) is known as a contractual adjustment or write-off. This amount is written off by the provider as part of their agreement with the insurance company and is not billed to the patient. A deductible is a fixed amount the patient must pay out-of-pocket before the insurance plan starts to pay. A co-payment is a fixed fee the patient pays for a service, often at the time of the visit. A credit balance occurs when an account has been overpaid.
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