Customary Charge definition

Customary Charge is the fee for health care services charged by Medical Group that does not exceed the fee Medical Group would ordinarily charge another person regardless of whether the person is a Customer.

Customary Charge. The fee for MHSA Services charged by Provider that does not exceed the fee Provider would ordinarily charge any other person regardless of whether the person is a Member.

Customary Charge means the average charge for a similar service, activity or procedure for non-departmental clients or purchasers by providers whose training and experience is similar to the contractor or subcontractor and are located in the same area. The area considered in determining customary charge shall be as large as necessary to provide a reasonable measure of the market for such services, activities or procedures.

Examples of Customary Charge in a sentence

• Charges for an assistant surgeon are covered up to 20% of the Usual, Reasonable and Customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.

• Where MetLife determines that there is inadequate charge information maintained in MetLife’s Reasonable and Customary Charge records for the geographic area in question, the Customary Charge will be determined based on actuarially sound principles.An example of how the 90th percentile is calculated is to assume one hundred (100) charges for the same service are contained in MetLife’s Reasonable and Customary charge records.

• Covered Charge: The Reasonable and Customary charge incurred for a service or supply listed in this certificate which is performed or given under the direction of a Doctor for the Medically Necessary treatment of an Injury caused by an Accident.

• Charges for an assistant surgeon are covered up to 20% of the Usual and Customary charge of the primary surgeon.

• No more than the Reasonable and Customary charge less coinsurance will be considered by the Program for medically necessary covered services.

More Definitions of Customary Charge

Customary Charge means the usual rates or range of fees charged by health care providers in a given locale or area.

Customary Charge means a charge within the range of usual charges for a given service billed by most providers with similar training and experience taking into consideration the geographic area in which the services are provided and significant regional variations in the cost of services.

Customary Charge means the average charge for the service or supply in the geographic area concerned, as determined by the Trust Fund Administrator.

Customary Charge means the fee for a medical service which is no greater than the average and prevailing charge for the same service in the same geographic community, or in a geographic community which is similar to that in which the service is rendered.

Customary Charge. The fee for health care services charged by Ancillary Provider that does not exceed the fee Ancillary Provider would ordinarily charge another person regardless of whether the person is a Customer. Customer Expenses: Copayments, deductibles or coinsurance that are the financial responsibility of the Customer according to the Customer’s Benefit Plan.

Customary Charge. The usual, reasonable and customary fees charged by a Participating Provider which do not exceed the fees the Participating Provider would charge any other person, regardless of whether the person is an Enrollee.

Customary Charge means the average charge for a similar service, activity or procedure for non-HCA clients or purchasers by providers whose training and experience is similar to the Contractor or Subcontractor and are located in the same area. The area considered in determining Customary Charge shall be as large as necessary to provide a reasonable measure of the market for such services, activities or procedures.