Let’s try to explain this as fast as possible!

Let’s say you bill your full billed fee of $150 to an insurance company.

They adjust your fee down by $50, which is the adjusted amount. You are not allowed to collect this amount from anyone, so do not charge this extra to the patient. That is considered insurance fraud even though many providers have the wrong idea about it!

The patient has a $20 copay, which is the patient responsibility.

The insurance company reimburses you for $80, which is the insurance reimbursement amount.

Putting It Together

Your full fee ($150) – the adjusted amount ($50 ) = the total amount ($100)  [which is the patient responsibility ($20) + insurance reimbursement ($80)].