According to the St. Bernardine Medical Center, a contractual adjustment is part of the bill that a hospital has agreed not to charge a patient because of billing agreements with the patient's insurance company. It is the most common type of adjustment made by medical providers.Know More
A contractual adjustment shows up on a billing statement as an adjustment required, and it decreases the balance. When a medical provider accepts an insurance plan, the contract includes details such as the amount the insurance company pays the provider for certain procedures. Since the provider charges more than what the insurance company agrees to pay, the amount that is paid by the company is known as an allowable amount, and the amount above that is the reduction, made by the provider, called contractual adjustment. Providers that participate in this agreement believe that the broader access to members is worth the contracted rates on services. Additionally, it ensures that providers are paid a significant portion of the fee, which patients without insurance cannot afford.
Contractual agreements are only made on services covered by the insurance company. A patient who undergoes a procedure that is not covered must pay the full amount charged by the medical provider without any contractual agreement to limit the cost.Learn more about Health Insurance
In order to find a doctor accepting new patients and insurance, it may be necessary to contact the insurance company, ask for recommendations from friends or colleagues or use websites, such as the Medicare website for more information. Finding the right doctor is key to receiving timely treatment and sound advice on how to stay healthy for a better future, according to Medicare.Full Answer >
Generally, most health insurance policies cover certain treatments for many types of cancer, including spinal cancer, although the individual's insurance company and policy can factor into specific coverage. To ensure insurance coverage, check with the insurance policy or the insurance company.Full Answer >
Medicare Part A is provided free of charge to qualifying individuals, but Part B costs a minimum of $104.90 per month as of 2015. Participants of any age are eligible as long as they meet medical and employment conditions.Full Answer >
Doctors can charge for missed appointments. The American Medical Association states that such charges are allowable if a patient did not cancel 24 hours in advance and is aware that the doctor may impose such a charge.Full Answer >