Allowable Charges for Covered Services Sample Clauses

Allowable Charges for Covered Services. The sharing is expressed as a percentage. Once the Member has met any applicable Deductible, Claims Administrator's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Company – Means Blue Cross and Blue Shield of Louisiana, or United Concordia Dental when it acts on Blue Cross and Blue Shield of Louisiana’s behalf. Complaint – An oral expression of dissatisfaction with the dental plan or Provider services. Cosmetic Surgery/Treatment – Any operative procedure, treatment, or service or any portion of an operative procedure, treatment or service performed primarily to improve physical appearance. An operative procedure, treatment or service is not considered Cosmetic Surgery if restores bodily function or corrects deformity to restore function of a part of the body that an Accidental Injury, disease or disorder, or covered Surgery has altered.
Sample 1Sample 2Sample 3See All (9)
AutoNDA by SimpleDocs
Allowable Charges for Covered Services. The sharing is expressed as a percentage. Once the Member has met any applicable Deductible, Claims Administrator's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Company – Means Blue Cross and Blue Shield of Louisiana, or United Concordia Dental when it acts on Blue Cross and Blue Shield of Louisiana’s behalf. Complaint – An oral expression of dissatisfaction with the dental plan or Provider services. Cosmetic Surgery/Treatment – Any procedure or any portion of a procedure performed primarily to improve physical appearance. A procedure, treatment or service will not be considered Cosmetic Surgery or treatment if that procedure, treatment or service restores bodily function or corrects deformity of a part of the body that has been altered as a result of Accidental Injury, disease or disorder, or covered surgery.
Sample 1Sample 2
Allowable Charges for Covered Services. The sharing is expressed as a percentage. Once the Member has met any applicable Deductible, Claims Administrator's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Complaint – An oral expression of dissatisfaction with the dental plan or Provider services. Company – Means Blue Cross and Blue Shield of Louisiana. Cosmetic Surgery/Treatment – Any procedure or any portion of a procedure performed primarily to improve physical appearance. A procedure, treatment or service will not be considered Cosmetic Surgery or treatment if that procedure, treatment or service restores bodily function or corrects deformity of a part of the body that has been altered as a result of Accidental Injury, disease, disorder or covered surgery.
Sample 1Sample 2
Allowable Charges for Covered Services. The sharing is expressed as a pair of percentages, a percentage that We pay, and a Plan Participant percentage that You pay. Once the Plan Participant has met any applicable Deductible, the Plan Participant’s percentage will be applied to the Allowable Charges for Covered Services to determine the Plan Participant’s financial responsibility. The Plan Administrator's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Company – Blue Cross and Blue Shield of Louisiana (incorporated as Louisiana Health Service & Indemnity Company) or United Concordia Dental when it acts on Blue Cross and Blue Shield of Louisiana’s behalf. Complaint – An oral expression of dissatisfaction with the Claims Administrator or Provider services. Concurrent Review – A review of Medical Necessity, appropriateness of care, or level of care conducted during a course of treatment. Cosmetic Surgery/Treatment – Any procedure or any portion of a procedure performed primarily to improve physical appearance and/or treat a mental condition through change in bodily form. A procedure, treatment or service will not be considered Cosmetic Surgery or treatment if that procedure, treatment or service restores bodily function or corrects deformity of a part of the body that has been altered as a result of Accidental Injury, disease or covered surgery.
Sample 1
Allowable Charges for Covered Services. The sharing is expressed as a percentage. Once the Member has met any applicable Deductible, UCD's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Complaint – An oral expression of dissatisfaction with the dental plan or Provider services. Company – Means Blue Cross and Blue Shield of Louisiana. Cosmetic Surgery/Treatment – Any operative procedure, treatment, or service, or any portion of an operative procedure, treatment or servcie performed primarily to improve physical appearance. An operative procedure, treatment or service is not considered Cosmetic Surgery or treatment if restores bodily function or corrects deformity to restore function of a part of the body that an Accidental Injury, disease, disorder or covered Surgery has altered.
Sample 1
Allowable Charges for Covered Services. The sharing is expressed as a percentage. Once the Member has met any applicable Deductible, UCD's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Company – Means Blue Cross and Blue Shield of Louisiana, or United Concordia Dental when it acts on Blue Cross and Blue Shield of Louisiana’s behalf. Complaint – An oral expression of dissatisfaction with the dental plan or Provider services. Cosmetic Surgery/Treatment – Any procedure or any portion of a procedure performed primarily to improve physical appearance. A procedure, treatment or service will not be considered Cosmetic Surgery or treatment if that procedure, treatment or service restores bodily function or corrects deformity of a part of the body that has been altered as a result of Accidental Injury, disease, disorder or covered surgery. Covered Service – A service or supply specified in this Benefit Plan for which Benefits are available when rendered by a Provider. Crown – A tooth-shaped cap that is placed over a tooth to cover it and restore its shape and size, strength, and improve its appearance. When a crown is cemented into place, it fully encases the entire visible portion of a tooth that lies at and above the gum line. Deductible – The dollar amount, if shown in the Schedule of Dental Benefits, of Allowable Charges for Covered Services that each Member must pay within a Benefit Period before payments are made under this Benefit Plan. If shown in the Schedule of Benefits, the Deductible may be waived for certain services. Dental Care and Treatment – All procedures, treatment, and surgery considered to be within the scope of the practice of dentistry, which is defined as that practice in which a person:
Sample 1
Allowable Charges for Covered Services. The sharing is expressed as a pair of percentages, a percentage that We pay, and a Plan Participant percentage that You pay. Once the Plan Participant has met any applicable Deductible, the Plan Participant’s percentage will be applied to the Allowable Charges for Covered Services to determine the Plan Participant’s financial responsibility. The Plan Administrator's percentage will be applied to the Allowable Charge for Covered Services to determine the Benefits provided. Company – Blue Cross and Blue Shield of Louisiana, or United Concordia Dental when it acts on Blue Cross and Blue Shield of Louisiana’s behalf. Complaint – An oral expression of dissatisfaction with the Claims Administrator or Provider services. Concurrent Review – A review of Medical Necessity, appropriateness of care, or level of care conducted during a course of treatment. Cosmetic Surgery/Treatment – Any procedure or any portion of a procedure performed primarily to improve physical appearance. A procedure, treatment or service will not be considered Cosmetic Surgery or treatment if that procedure, treatment or service restores bodily function or corrects deformity of a part of the body that has been altered as a result of Accidental Injury, disease or disorder, or covered surgery.
Sample 1
AutoNDA by SimpleDocs

Related to Allowable Charges for Covered Services

  • Subcontract Costs Payments made by the Construction Manager to Subcontractors in accordance with the requirements of the subcontracts.

  • Allowable Costs Allowable Costs are restricted to costs that comply with the Texas Uniform Grant Management Standards (UGMS) and applicable state and federal rules and law. The Parties agree that all the requirements of the UGMS apply to this Contract, including the criteria for Allowable Costs. Additional federal requirements apply if this Contract is funded, in whole or in part, with federal funds.

  • Professional Services Fees You agree to pay us the professional services fees in the amounts set forth in the Investment Summary. Those amounts are payable in accordance with our Invoicing and Payment Policy. You acknowledge that the fees stated in the Investment Summary are good-faith estimates of the amount of time and materials required for your implementation. We will bill you the actual fees incurred based on the in-scope services provided to you. Any discrepancies in the total values set forth in the Investment Summary will be resolved by multiplying the applicable hourly rate by the quoted hours.

  • Medical Expenses 1. Employees exposed to hazardous physical, biological, or chemical agents shall be provided, at no cost to the employee, with medical examinations or evaluations required by VOSHA regulations. If there are no specific VOSHA regulations or standards for the agent in question, recommendations of the National Institute of Occupational Safety and Health or other generally recognized expert organization shall be used, as determined by the Commissioner of Health.

  • Reimbursement of Travel Expenses If the Servicer provides access to the Review Materials at one of its properties, the Issuer will reimburse the Asset Representations Reviewer for its reasonable travel expenses incurred in connection with the Review on receipt of a detailed invoice.

  • Travel Expenses CONTRACTOR shall not be allowed or paid travel expenses unless set forth in this Agreement.

  • Services Fees The Fees are stated on the Stripe Pricing Page, unless you and Stripe otherwise agree in writing. Stripe may revise the Fees at any time. If Stripe revises the Fees for a Service that you are currently using, Stripe will notify you at least 30 days (or a longer period if Law requires) before the revised Fees apply to you.

  • Allowable Expenses Contractor may submit for reimbursement, without mark-up, only the following categories of expense: • •

  • Child Care Expenses (a) Where an employee is requested or required by the Employer to attend:

  • Additional Services Fees Payments to the Design Professional on account of Additional Services shall be made as follows:

Time is Money Join Law Insider Premium to draft better contracts faster.