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Health Term Glossary

Adjusted Gross Income
is an income figure computed when calculating taxes. It is based on gross income, less any business expenses and deductions like retirement account contributions or alimony. Itemized deductions, such as medical expenses, interest payments, and real estate taxes, are included in the adjusted gross income calculation and not subtracted out until "net taxable income" is determined.

Adjustment
(see Network Discount)

Allied Practitioner
is a professionally degreed healthcare service provider other than a Physician M.D.

Allowed Amount
usually refers to the amount of payment a provider has agreed to accept for a service, treatment, or product under the terms of their negotiated contract with the insurance company. This can also refer to the maximum amount the insurance company will "allow" a provider to bill for a service, whether they are in or out-of-network (also see related Adjusted Amount, Allowable Rate, Negotiated Rate)

Amount Applied to Deductible
is the amount of a patient responsibility which is credited against the deductible in a healthcare plan.

Amount Charged
the amount initially billed by a healthcare provider for services, treatment, or products.

Appealing a denial
is the process one must complete to contest a denied medical claim. Most insurance carriers have their own processes for appealing a denial.

Adjusted Amount
is the amount by which a provider's bill is adjusted as a result of a negotiated rate covered under a negotiated capitated contract between the provider and the insurer (see also Allowed Amount, Allowable Rate, Negotiated Rate).

Allowable Rate
is the rate to which a provider's bill is adjusted based upon a negotiated capitated contract between the provider and the insurer (see also Adjusted Amount, Negotiated Rate, Allowed Amount).