Allowed Charges definition

Allowed Charges means the maximum amount for any procedure or service that the department allows as the basis for payment computation.

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Allowed Charges or “Allowable Charges” shall mean charges reviewed and approved under an appropriate audit and utilization review by the carrier as prescribed in the Division’s Rules, or as determined by the Commissioner or the Commissioner’s designee after consultation with the Division’s Medical Director.

Allowed Charges means approved charges Licensees are permitted to levy from customers, prospective customers and the general public for carrying out work requested by them;

Examples of Allowed Charges in a sentence

Claims for covered Emergency Services are paid based on the Allowed Charges as defined in the EOC.
Claims for covered Emergency Services are paid based on the Allowed Charges as defined in this Evidence of Coverage.
Non-Participating Providers do not have a contract with Blue Shield to accept Blue Shield’s Allowed Charges as payment in full for Covered Services.
See the Your payment information section for more information about the Allowed Charges.
Once you reach your Out-of-Pocket Maximum, Blue Shield will pay 100% of the Allowed Charges for Covered Services.
Once you reach your Deductible, Blue Shield will pay the Allowed Charges for Covered Services, minus your Copayment or Coinsurance amounts, until you reach your Out-of-Pocket Maximum.
The Non-Participating Provider must agree to accept Blue Shield’s Allowed Charges as payment in full for your ongoing care.
Once you reach your Out-of-Pocket Maximum, Blue Shield will pay 100% of the Allowed Charges for Covered Services for the rest of the Calendar Year.
Participating Providers agree to accept the Allowed Charges as payment in full for Covered Services provided or arranged by Blue Shield, except as stated in the Exception for other coverage and Reductions – third party liability sections.
For Covered Services that are subject to your plan’s Deductible, you are also responsible for all costs up to the Allowed Charges until you reach your Deductible.

More Definitions of Allowed Charges

Allowed Charges or “Allowable Charges” shall mean charges as prescribed in the Bureau’s Rules, or as determined by the Administrator or the Administrator’s designee after consultation with the Bureau’s Medical Director.

Allowed Charges or “Allowable Charges” shall mean charges reviewed and approved under an appropriate audit and utilization review by the carrier as prescribed in the BureauDivision’s Rules, or as determined by the Administrator or the Administrator’s designee after consultation with the BureauDivision’s Medical Director.

Allowed Charges means charges for services allowed by Our agreement with the Network Providers or an amount determined under a fee schedule used by Us in a part of Our Service Area. Allowed Charges are not reduced by amounts withheld by Us from payments for Care provided by Network Providers or due to any other provider incentive plan, or by any rebates We may get.

Allowed Charges means the maximum amount reim- bursed for any procedure that is allowed by the department.