Maximum reimbursement allowance

Definition

The state's own price list for treating an injured worker, which the clinic may not bill around.

Why It Matters

It turns the occupational medicine premium into arithmetic. Florida pays 175 percent of Medicare for a physician visit, which is genuinely better than the walk-in book's worst payers and genuinely not yours to improve, because a three-member panel moves the number and the department republishes the schedule. Underwrite it as a regulated price carrying legislative risk. The second half is quieter: carrier authorization is a condition of payment except in emergencies, and the clinic may not then bill the patient for what was unauthorized. So the book carries a write-off line the practice management system will produce and the seller's profit and loss will not.