Contractual adjustment missing
Insurance discounted the bill. The provider still billed the old price.
The EOB showed a negotiated allowed amount and a contractual adjustment. The provider statement did not apply that adjustment before calculating the patient balance.
Original charge$1,240
Allowed amount$620
Missing adjustment$620
What happened
1
The provider charged full price
The invoice started from a $1,240 service charge and carried most of that amount forward as the basis for the balance.
2
The EOB reduced the claim
The insurer allowed $620 and showed the remaining $620 as a contractual adjustment, not something the patient should pay.
3
The missing credit was isolated
Insured Guard found that the provider bill did not reflect the adjustment and highlighted the uncredited amount.
A contractual adjustment is not a discount to remember later. It should already be on the bill.
How do we know
It follows the allowed amount, not the sticker price.
Insured Guard compares the provider statement to the EOB allowed amount and adjustment fields. If a bill calculates the balance from the original charge after insurance has reduced it, the missing adjustment is flagged.