Reasonable and Customary Charges definition

Reasonable and Customary Charges means expenses which:
Reasonable and Customary Charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the Illness / Injury involved.
Reasonable and Customary Charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the illness / injury involved.

Examples of Reasonable and Customary Charges in a sentence

  • INTENSIVE CARE UNIT - Reimbursement of the Reasonable and Customary Charges Medically Necessary for actual room and board incurred during confinement as an in-patient in the Intensive Care Unit of the Hospital.

  • We will pay Reasonable and Customary Charges for the most economical cost of travel (transport only) for the Insured Person.

  • If We have accepted a claim for Critical Illness, in accordance with Section II.A in respect of an Insured Person, which results in mental trauma, then in addition to any amount payable under that Section,, We will reimburse the amount up to the limit specified against this benefit in the Policy Schedule towards the Reasonable and Customary Charges incurred for Medically necessary counselling and specialist consultation and extended physiotherapy on an out-patient basis,.

  • If an Insured Person is Hospitalised as an In-patient during the Policy Period on the advice of a Medical Practitioner due to an Accidental Injury sustained during the Policy Period then We will reimburse the amount up to the limit specified against this benefit in the Policy Schedule, towards the Reasonable and Customary Charges for Medical Expenses incurred in respect of medical treatment or Surgery for the Injury sustained, provided that the treatment is availed in a Hospital or Day Care Centre.

  • ANAESTHETIST FEE - Reimbursement of the Reasonable and Customary Charges by the Anaesthetist for the Medically Necessary administration of anaesthesia not exceeding the limits as set forth in the Schedule of Benefit.


More Definitions of Reasonable and Customary Charges

Reasonable and Customary Charges means an expense which:
Reasonable and Customary Charges means charges based
Reasonable and Customary Charges means charges for medical care which is medically necessary shall be considered reasonable and customary to the extent that it does not exceed the general level of charges being made by others of similar standing in the locality where the charge is incurred, when furnishing like or comparable treatment, services or supplies to individual of the same sex and of comparable age for a similar sickness, disease or injury and in accordance with accepted medical standards and practice could not have been omitted without adversely affecting the Insured Person’s medical condition.
Reasonable and Customary Charges means charges based upon the 90th percentile of the usual, customary, and reasonable (UCR) fee schedule determined by the Health Insurance Association of America or a similar nationally recognized database of prevailing health care charges.
Reasonable and Customary Charges means charges that are, as determined by Us, comparable to other charges for the same service and level of expertise in the place where the Emergency took place.
Reasonable and Customary Charges means charges commonly used by Physicians in the locality in which care is furnished.
Reasonable and Customary Charges means charges for medical care which shall be considered by the Company or its medical advisers to be reasonable and customary to the extent that they do not exceed the general level of charges being made by others of similar standing in the locality where the charges are incurred when giving like or comparable treatment, services or supplies to individuals of the same sex and of comparable age for a similar disease or Illness or Injury. Any scales of charges which may be agreed from time to time between the Company and Hospitals and Doctors shall also be indicative of such Reasonable and Customary Charges.