Author Question: How could a physician end up getting paid less than the allowable rate for a certain service? a. ... (Read 38 times)

mynx · **on:** Jun 27, 2018

How could a physician end up getting paid less than the allowable rate for a certain service?

a. The billing was done incorrectly.
b. The UCR factors were entered incorrectly.
c. The physician's usual fee is less than the allowable amount.
d. The biller coded the wrong diagnosis.

Question 2

What is subtracted by the insurance company from the allowable amount prior to payment?

a. Deductible, coinsurance, copayments
b. Nothing
c. Deductible and copayments only
d. Deductible only