Tag: Payer Contract Management

Contractual adjustments are a routine part of medical billing, but inaccurate adjustments can create significant problems for healthcare practices. When a provider participates in an insurance network, the contract generally establishes how covered services are reimbursed and which amounts must be adjusted according to the applicable terms. Billing teams must apply these rules consistently to […]

Receiving an insurance payment does not always mean a medical claim has been reimbursed correctly. A claim may be processed and paid while the reimbursement remains below the amount allowed under the applicable payer contract. These discrepancies can occur because of incorrect fee schedules, contractual adjustments, processing errors, missing payment information, or misunderstandings about payer […]