An insurance adjustment refers to the difference in amount between what the provider charged and which of the following?

An insurance adjustment is the difference in amount between what a healthcare provider charges for a service and the amount that the provider has agreed to accept from an insurance company as payment. This contracted amount is established through negotiated agreements between the healthcare provider and the insurance company.

When a provider submits a claim to an insurance company, the insurance company assesses the claim based on their predetermined rates for services, which often differ from the provider's usual charges. The adjustment reflects this negotiated difference, resulting in the provider receiving a lower payment than what was originally billed.

The other terms mentioned—such as explanation of benefits, remittance advice, and net claim benefit—are related to the billing and payment process but do not specifically define the concept of insurance adjustment. The explanation of benefits details what the insurance company covered, the remittance advice outlines payments made and amounts adjusted, while the net claim benefit refers to the final payment amount after adjustments but does not define the adjustment itself.