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 expenses which:
Reasonable and Customary Charges means an expense which:
Examples of Reasonable and Customary Charges in a sentence
After the individual Insured Person pays the Deductible, the plan covers Usual, Reasonable and Customary Charges of the Covered Expenses subject to Copayments, Coinsurance, any Maximum Benefit amounts and Policy Period Maximum amounts.
We will only reimburse Out-of-Network Providers the Coinsurance amount (as stated in What Your Plan Covers) of the Usual, Reasonable and Customary Charges (except when such Services are Medical Emergency Services).
More Definitions of Reasonable and Customary Charges
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 usual amount charged for treatment, supplies or medical services in the locality where such expense is incurred and does not include charges that would not have been made if no insurance existed.
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.