Reasonable and/or Reasonableness definition

Reasonable and/or Reasonableness means, in the plan administrator’s discretion, services or supplies, or fees for services or supplies which are necessary for the care and treatment of illness or injury not caused by the treating Provider’s error or mistake. Determination that fee(s) or services are reasonable will be made by the Plan Administrator, taking into consideration unusual circumstances or complications requiring additional time, skill andexperience in connection with a particular service or supply; industry standards and practices as they relate to similar scenarios; and the cause of injury or illness necessitating the service(s) and/or charge(s).this determination will consider, but will not be limited to evidence-based guidelines, and the findings and assessments of the following entities: (a) The National Medical Associa- tions, Societies, and organizations; (b) Centers for Medicare and Medicaid Services (CMS); and (c) The Food and Drug Administration (FDA). A finding of Provider negligence and/or malpractice is not required for service(s) and/or fee(s) to be considered not reasonable.to be reasonable, service(s) and/or fee(s) must be in compliance with generally accepted billing practices for unbundling or multiple procedures. the plan administrator retains discretionary authority to determine whether service(s) and/or fee(s) are reasonable based upon information presented to the plan administrator.the plan administrator reserves for itself and parties acting on its behalf the right to review charges processed and/or paid by the plan, to identify charge(s) and/or service(s) that are not reasonable and therefore not eligible for payment by the plan.
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Examples of Reasonable and/or Reasonableness in a sentence

  • Reasonable and/or Reasonableness Shall mean in Alliant’s discretion, services or supplies, which are necessary for the care and treatment of illness or injury not caused by the treating Provider.

  • Reasonable and/or Reasonableness shall mean in the administrator’s discretion, services or supplies, or fees for services or supplies, which are necessary for the care and treatment of illness or injury not caused by the treating Provider.

  • Reasonable and/or Reasonableness shall mean in the administrator’s discretion, services or supplies, or fees for services or supplies which are necessary for the care and treatment of illness or injury not caused by the treating Provider.

  • Reasonable and/or Reasonableness Shall mean in Alliant’s discretion, services or supplies, whichare necessary for the care and treatment of illness or injury not caused by the treating Provider.

  • Reasonable and/or Reasonableness shall mean in the administrator’s discretion, servic- es or supplies, or fees for services or supplies which are necessary for the care and treatment of illness or injury not caused by the treating Provider.

  • Other income in 1995 included non-recurring income of $39.0 million resulting from the settlement of a Columbia Gas Transmission Corporation bankruptcy claim with Samedan.

  • Reasonable and/or Reasonableness means services or supplies, or fees for services or supplies which are necessary for the care and treatment of illness or injury not caused by the treating Provider.

  • Upkeep is defined as ‘‘the act of maintaining in good condition ’’ Webster’s Third New International Dictionary (2002).

Related to Reasonable and/or Reasonableness

  • Reasonable and Customary means, in relation to a charge for Medical Service, such level which does not exceed the general range of charges being charged by the relevant service providers in the locality where the charge is incurred for similar treatment, services or supplies to individuals with similar conditions, e.g. of the same sex and similar Age, for a similar Disability, as reasonably determined by the Company in utmost good faith. The Reasonable and Customary charges shall not in any event exceed the actual charges incurred.

  • reasonable possibility means that there is a cause and effect relationship between the investigational product, study device and/or study procedure and the AE.

  • Reasonable grounds means that a reasonable person in your position would also suspect the information indicates misconduct or a breach of the law.

  • believes “expects”, “aims”, “intends”, “will”, “may”, “shall”, “should”, “anticipates”, “estimates”, “projects”, “is subject to”, “budget”, “scheduled”, “forecast” or words or terms of similar substance or the negative thereof, are forward looking statements. Forward looking statements include statements relating to the following: (i) future capital expenditures, expenses, revenues, earnings, synergies, economic performance, indebtedness, financial condition, dividend policy, losses and future prospects; (ii) business and management strategies and the expansion and growth of Bidco’s or Xxxx Xxxxx’x operations and potential synergies resulting from the Acquisition; and (iii) the effects of government regulation on Bidco’s or Xxxx Xxxxx’x business. Such forward looking statements are prospective in nature and are not based on historical facts, but rather on current expectations and projections of the management of Bidco and Xxxx Xxxxx about future events, and are therefore subject to risks and uncertainties that could significantly affect expected results and are based on certain key assumptions. Many factors could cause actual results to differ materially from those projected or implied in any forward looking statements, including: increased competition, the loss of or damage to one or more key customer relationships, changes to customer ordering patterns, delays in obtaining customer approvals for engineering or price level changes, the failure of one or more key suppliers, the outcome of business or industry restructuring, the outcome of any litigation, changes in economic conditions, currency fluctuations, changes in interest and tax rates, changes in raw material or energy market prices, changes in laws, regulations or regulatory policies, developments in legal or public policy doctrines, technological developments, the failure to retain key management, or the timing and success of future acquisition opportunities or major investment projects. Other unknown or unpredictable factors could cause actual results to differ materially from those in the forward looking statements. Such forward looking statements should therefore be construed in the light of such factors. Neither Bidco nor Xxxx Xxxxx, nor any of their respective associates or directors, officers or advisers, provides any representation, assurance or guarantee that the occurrence of the events expressed or implied in any forward looking statements in this Announcement will actually occur. Due to such uncertainties and risks, readers are cautioned not to place undue reliance on such forward looking statements, which speak only as of the date hereof. All subsequent oral or written forward looking statements attributable to any member of the Bidco Group or the Xxxx Xxxxx Group, or any of their respective associates, directors, officers, employees or advisers, are expressly qualified in their entirety by the cautionary statement above. Bidco and Xxxx Xxxxx expressly disclaim any obligation to update any forward looking or other statements contained herein, except as required by applicable law or by the rules of any competent regulatory authority, whether as a result of new information, future events or otherwise.

  • Reasonable access for the purposes of this section means:

  • Reasonable Best Efforts means best efforts, to the extent commercially reasonable.

  • fair and reasonable conditions means appropriate conditions, including possible financial terms or royalty-free conditions, taking into account the specific circumstances of the request for access, for example the actual or potential value of the results or background to which access is requested and/or the scope, duration or other characteristics of the exploitation envisaged;

  • Reasonable cost means a cost for a service or item that is consistent with the market standards for comparable services or items.

  • Knowledge means actual knowledge after reasonable investigation.

  • Reasonable in the circumstances means using no more force than is needed.

  • Reasonable Commercial Efforts means, with respect to the applicable obligation of the Company, reasonable commercial efforts for similarly situated, publicly-traded companies.

  • Good means all of the equipment, machinery, and/or other materials that the supplier is required to supply to the purchaser under the contract.

  • Reasonable inquiry means an inquiry designed to uncover any information in the entity's possession about the identity of the producer or provider of covered telecommunications equipment or services used by the entity that excludes the need to include an internal or third-party audit.

  • Reasonable and prudent parent standard means the

  • As low as is reasonably achievable (ALARA) means making every reasonable effort to maintain exposures to radiation as far below the dose limits in these regulations as is practical, consistent with the purpose for which the licensed or registered activity is undertaken, taking into account the state of technology, the economics of improvements in relation to state of technology, the economics of improvements in relation to benefits to the public health and safety, and other societal and socioeconomic considerations, and in relation to utilization of nuclear energy and licensed or registered sources of radiation in the public interest.

  • Reasonable suspicion means a basis for forming a belief based on specific facts and rational inferences drawn from those facts.

  • Reasonable accommodation means necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden, where needed in a particular case, to ensure to persons with disabilities the enjoyment or exercise on an equal basis with others of all human rights and fundamental freedoms;

  • reasonable measures means appropriate measures which are commensurate with the money laundering or terrorism financing risks;

  • good faith means that degree of diligence which a reasonable person would exercise in the performance of legal duties and obligations;

  • Reasonable Steps means those steps the Receiving Party takes to protect its own similar proprietary and confidential information, which must not be less than a reasonable standard of care.

  • Reasonable Care means the use of reasonable custodial practices under the applicable circumstances as measured by the custodial practices then prevailing in Russia of International Financial Institutions acting as custodians for their institutional investor clients in Russia.

  • Reasonable person means a reasonable person under similar circumstances and with similar identities to the victim.

  • Reasonable Distance means a distance that has regard to the Employee’s original work location, current home address, capacity of the Employee to travel, additional travelling time, effects on the personal circumstances of the affected Employee, including family commitments and responsibilities and other matters raised by the Employee, or assistance provided by their Employer.

  • Developmentally appropriate means suitable to the chronological age range and developmental characteristics of a specific group of children.

  • Medically Appropriate means services and medical supplies required for prevention, diagnosis, or treatment of a physical or behavioral health condition or injuries that are:

  • Reasonable and Prudent Operator means a person seeking in good faith to perform its contractual obligations and, in the process of doing so and in the overall conduct of its whole undertaking exercising that degree of diligence, skill, prudence and foresight which can reasonably and ordinarily be expected from a skilled and experienced operator engaged in the same type of undertaking under the same or similar circumstances complying with all applicable Laws, and any reference to the standard of a Reasonable and Prudent Operator means such degree of diligence, skill, prudence and foresight as aforesaid.