Contractual Allowances

501 Words2 Pages

In week 2, I will be discussing a table showing the contracted payer, contracted rate, and contractual allowance. I will show the table below with and discuss how on could increase or decrease revenue in this system. Lastly, I will then describe how I could increase revenue or realize loss in this system. My conclusion will be an overview of my findings and what is importance. Use the following data to complete a table showing the established rate (Column A), contracted rate (Column B) and the difference (Column A minus Column B) as a contractual allowance for each payer. Then, briefly discuss how one could increase or decrease revenue in this system. A physician office's revenue for visit code 99214 has a full established rate of $72.00. There are 10 different payers; there are nine different contracted rates, as follows:
• Set up a worksheet with four columns: Payer, Full …show more content…

First, what is contracted rate and the contractual allowance? “Contractual allowances are the difference between the full established rate and the agree-upon contractual rate that will be paid” (Baker & Baker, 2013, p. 32). I think the increase in the full rate could equal to an increase in contractual allowances. What I see here is that ten contracted payers and six of them have a realized loss in revenue, which is a decrease in revenue. As I stated before, to increase the revenue one would need to increase the full rate. By subtracting the full rate from the contracted rate, it would equal the contractual allowance. Our textbook also states, “It is not uncommon for different plans to pay different contractual rates for the same services” (Baker & Baker, 2013, p. 33). Concluding to my end statement, different plans (the payer) could charge a different full rate than other plans for the same services and receive more revenue by increasing the full rate in

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