Approved amount

The amount of that insurance company agrees to pay or a service to a patient.. Varies from company to company, except in the case of certain specialized icing structures, such as state Worker’s Compensation. Occasionally, approved amounts are based on state Worker’s Compensation, or Medicare approved amounts. While ideally based on actuarial information or a consensus amongst providers, these may be arbitrary dollar caps on service charges, in order to reduce contract charges for an insurance company.