Example 03: Claim Specific Negotiated Discount

Example 03: Claim Specific Negotiated Discount X12 Admin Wed, 07/29/2026 - 08:18 In this example the provider and payer came to an agreed upon amount for allowance for these specific services billed which happened to be less than billed charges. The difference between the billed charge and the negotiated amount is shown as an adjustment in a RAS segment. The claim adjustment reason code would be 131 “Claim specific negotiated discount”.