Contractual Amount means the amount to be paid to the SUPPLIER in accordance with the CONTRACT for total compliance with its contractual obligations.
The contracted rate is the total amount (including cost sharing) that a group health plan or health insurance issuer has contractually agreed to pay a participating provider, facility, or provider of air ambulance services for covered items and services, whether directly or indirectly, including through a third-party ...
CO (Contractual Obligation) assigns financial responsibility to the provider. When CO is used to describe an adjustment, a provider is not permitted to bill the beneficiary for the amount of that adjustment; or. PR (Patient Responsibility) assigns financial responsibility to the patient.
Answer and Explanation: The allowance for the contractual adjustment is the difference between the hospital bill of the personnel and the actual payment received by the hospital from the insurance company. The contractual adjustment is the amount of the bill not charged from the patients.
Adjustment/Contractual Adjustment - part of the bill that the hospital has agreed not to charge the patient because of billing agreements they have with the patient's insurance company.
A contractual allowance is the amount of discount from standard charges that is allowed by a particular payer for that service. For example, a hospital may charge $5,000 for an appendectomy, but based on terms of its negotiated United managed care contract, the amount United will pay is $3,000.
A contract is a written agreement between a customer and a provider (contractor). The customer, who is the owner of a job or project, requests a product or service. Your company, as the provider, bills the customer for the product or services that you provide under the contract.
CO-45 denial code is common in medical billing and can affect your revenue and cash flow. It means that your charges exceed the fee schedule or contract with the insurance company. To avoid or appeal this denial code, you should follow these steps: Review your contract terms and conditions with the insurance company.
One common example of a contractual obligation is the payment terms agreed upon between parties. These terms specify the amount, method, and schedule of payments. Similarly, delivery obligations outline the timeline, location, and conditions for delivering goods or services.
The Contract Amount represents the financial compensation that the contractor will receive from the project owner for completing the specified work according to the project plans, specifications, and conditions stipulated in the contract.
Contract rate: This is another term for interest rate. It refers to the percentage of money that a borrower has to pay back on top of the amount they borrowed. For example, if someone borrows $100 with a contract rate of 5%, they will have to pay back $105 in total.
Maximum Contract Amount means the maximum amount to be paid to the Consultant under this Contract, including all fees, allowances and reimbursable expenses as set out in Appendix 1 excluding any indirect taxes (including VAT) chargeable in respect of this Contract or the Services provided hereunder, which are not ...
Your contractual minimum payment is your PayDown Plan amount plus twice the amount of interest and fees on any balance not in the PayDown Plan. This ensures you're always paying back faster and keep your account out of persistent debt.
The Contract Amount means the total amount for which the Contractor has tendered to execute the contract work. Sample 1. The Contract Amount means the amount of money to be charged in respect of the individual contract for time and materials only and is specified in the Client Agreement.
Contractual limitations on damages are agreements whereby the parties limit or exclude the availability of damages that would otherwise be available under statutory law.
The maximum amount a plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.” If your provider charges more than the plan's allowed amount, you may have to pay the difference. ( See.
Denial CO 59 is used to indicate that multiple procedures or services were billed together when they should have been billed separately according to industry standards. This code suggests that the charges should be divided into distinct service lines to ensure accurate and transparent billing.
The CO 253 denial code refers to "services not covered by the payer." This means that the insurance provider has determined that the particular service or procedure is not covered under the patient's policy, resulting in a denial of payment.
Definitions: Contractual Allowances: Reductions in billed amounts based on agreements with insurers and government programs. Bad Debt Allowances: Estimates of amounts uncollectable from patients, recognized after collection efforts fail.
contractual payment means, with respect to a Finance Receivable, a payment due and payable as of a specified or determinable date under the terms thereof.
Contract medical refers to medical costs that have a predetermined total price and are not directly related to service rendered for medical services performed.
Health insurance organizations (payors) do the same thing. They negotiate private contracts with hospitals for discounts off their billed charges (equivalent to a manufacturers list price), and insurers end up paying different amounts to a hospital for the same procedure. This is called a contractual adjustment.
Contract Expenses means Exploration Expenses, Development Expenses, Operating Expenses, Service Costs, Market and Market Research Costs and General and Administrative Costs.
An allowance is an amount established in the contract documents for inclusion in the contract sum to cover the cost of prescribed items not specified in detail.