Dental reimbursement / TERM EXPLAINED
Contractual Adjustment
The reduction between a practice's charge and an applicable contracted allowance, when required by the participation agreement.
A dental practice example
A $1,000 charge is reduced to an $800 allowance, creating a $200 adjustment.
Why it matters for reimbursement
Changes in adjustments can reflect the price schedule, charge master or mix.
What to verify
Audit adjustments by CDT and payor against each executed fee schedule.
FROM DEFINITION TO DECISION
Turn reimbursement questions into evidence.
PayorMap helps dental groups connect disclosed negotiated rates, provider and network context, and contract details to meaningful benchmarking questions. Coverage and mapping confidence vary by payor and market.