Skip to main content
When balancing encounters and closing out A/R, Insights automatically resolves denial adjustments we’ve confirmed aren’t realistically workable. That works for common adjustments, but becomes less effective across the long tail of thousands of adjustment combinations. Target Allowed Amounts are a complementary strategy for that long tail.

​
What Is a Target Allowed Amount?

A Target Allowed Amount (TAA) answers the question: how much do you realistically expect to earn for this claim? With a TAA set, Insights can identify encounters where the payout is acceptable, write off the remaining balance, and finalize the encounter — reducing unnecessary inflation of your A/R metrics.

​
How Is a TAA Different from a Contracted Rate?

A contracted rate is what a payer is supposed to pay for a procedure; in practice they often pay less. A TAA is the amount your practice will accept for a claim configuration without pursuing further payment. The two are often close, with the TAA usually slightly lower.

​
How Do TAAs Work?

  • Insights identifies your most common claim configurations (a unique combination of procedures — CPT/modifier/units — plus payer and place of service).
  • Your Athelas team reviews the allowed amounts received for each configuration, discusses them with your practice, and together you agree on an acceptable TAA.
  • When the Adjustment Rules Engine System (ARES) finds an encounter matching that configuration with an allowed amount above the TAA, it writes off the remaining non-PR balance and resolves the encounter.

​
Setting Target Allowed Amounts

TAAs are set collaboratively with your practice through an Athelas-managed process — there isn’t a self-serve settings screen to configure them yourself. If you’d like to start using TAAs to get a clearer picture of your A/R and resolve more encounters, talk to your Account Manager to set up a TAA session. TAAs are entirely optional. Athelas recommends them, but the choice is yours.

​
FAQ

There’s no self-serve screen for TAAs — they’re set together with your Athelas team. Contact your Account Manager to schedule a TAA session.
No. They’re an optional tool to improve A/R accuracy and resolve encounters faster. You can choose not to use them.