Customary Fee definition
Examples of Customary Fee in a sentence
The term "Reasonable and Customary Fee" means the usual fee which an individual Physician most frequently charges to the majority of his or her patients for a like service or procedure to be determined by the prevailing range of fees in an area charged by most Physicians of similar training and experience for a like service or procedure (including consideration of unusual circumstances or medical complications requiring additional time, skill, or experience).
Co-Insurance*: Preventive 100% Basic Benefits 50% Major Services 50% Orthodontia 65% * Reimbursement Subject to Reasonable and Customary Fee.
D31.01 All "Full-time" and "Part-time" Employees are entitled to benefits governed by the Usual and Customary Fee Guide.
Co-Insurance*: * Reimbursement Subject to Reasonable and Customary Fee.
The Reasonable and Customary Fee Schedule is updated annually by the benefit carrier.
Claims payable will be reimbursed at the insurance providers Usual and Customary Fee Schedule.
Reasonable and Customary Fee Schedules are developed by the benefits carrier by comparing and studying the range of charges for comparable services in the same geographic area (Ontario).
You are responsible for any balance owed after our payment of the Usual and Customary Fee and your payment of any applicable Deductible, Copayment, or Coinsurance.
Your insurance company may base its dollar allowance on a fee schedule (Usual and Customary Fee) which differs from current fees for our region: in these cases you will be responsible for the remaining balance.
Emergency Dental Care outside the Service Area will be reimbursed at the Usual and Customary Fee.