Billed charges vs. Allowed amount vs. Contracted (negotiated) rate

Three different dollar figures can describe the same claim:

• Billed charges: What was invoiced to the payer. Usually the highest number, and not what you'd expect to actually collect.
• Allowed amount (reimbursed): What the payer actually paid. Closer to what landed in your account, though it still doesn't account for patient responsibility or write-offs.
• Contracted (negotiated) rate: What you're entitled to be paid per your contract with a payer, regardless of what any single claim happened to pay out.

Where this shows up:

Denial Intelligence's dollar figures are billed charges, so the real recoverable amount is typically lower. Reimbursement Intelligence's "Reimbursed" tab uses allowed amounts, while its "Negotiated" tab uses contracted rates, which is why the two tabs can tell different stories about the same payer. Encounter Coding Intelligence’s RVU differential figures are Medicare-payment estimates based on wRVUs, not your actual contracted reimbursement.