Reimbursement第 63 / 100 题
The 'allowed amount' on a claim is:
a.The provider's full billed charge
b.The maximum amount a payer will pay for a covered service under the contract or fee schedule
c.The patient's annual deductible
d.The amount written off as bad debt
解析
The allowed amount is the contracted or fee-schedule maximum the payer recognizes as payment for a covered service. It is often lower than the provider's billed charge, and the difference for a participating provider is a contractual write-off. Patient responsibility, such as coinsurance, is calculated from the allowed amount, not the billed charge.
法律依据: CMS免费刷完整 100 道题库 — 无需注册。
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