If a physician is contracted with an insurer to accept the allowed amount, and the insurer allows $80 of a $120 billed amount with $50 deductible not yet met, how much should be written off?

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Multiple Choice

If a physician is contracted with an insurer to accept the allowed amount, and the insurer allows $80 of a $120 billed amount with $50 deductible not yet met, how much should be written off?

When a provider has a contract to accept the insurer’s allowed amount, they write off the difference between what was billed and what the insurer allows as payment in full. Here, the billed amount is 120 and the allowed amount is 80, so the contractually adjusted write-off is 40. The deductible not yet met affects patient responsibility, not the write-off: the patient would owe the 50 deductible, and the insurer would pay the remaining 30 of the allowed amount, for a total collection of 80 (50 from patient, 30 from insurer).

When a provider has a contract to accept the insurer’s allowed amount, they write off the difference between what was billed and what the insurer allows as payment in full. Here, the billed amount is 120 and the allowed amount is 80, so the contractually adjusted write-off is 40. The deductible not yet met affects patient responsibility, not the write-off: the patient would owe the 50 deductible, and the insurer would pay the remaining 30 of the allowed amount, for a total collection of 80 (50 from patient, 30 from insurer).

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