Examples of Maximum Allowable Payment in a sentence
This is the fixed dollar amount (Copayment) or percentage (Coinsurance) of the Allowed Amount or Maximum Allowable Payment you have to pay when you receive these services.
Subject to Section 12.10, only those expenses for Covered Services submitted on Claims to AvMed will be credited toward the Calendar Year Deductible, and only up to the applicable Allowed Amount or Maximum Allowable Payment.
When, in the professional judgment of XxXxx's Medical Director, a Member needs covered Health Care Services or Hospital services which require skills or facilities not available from Participating Providers, and it is in the best interest of the Member to obtain the needed care from a Non-Participating Provider, upon authorization by the Medical Director, payment not to exceed the Maximum Allowable Payment, will be made for such Covered Services rendered by a Non-Participating Provider.
If your Plan includes a Family Calendar Year Out-of-Pocket Maximum, once your family has reached the Family Calendar Year Out-of-Pocket Maximum amount shown in your Schedule of Benefits, we will pay for Covered Services received by you and your Covered Dependents during the remainder of that Calendar Year at 100% of the Allowed Amount or Maximum Allowable Payment.
Subject to Section 12.9, only those expenses for Covered Services submitted on Claims to AvMed will be credited toward the Calendar Year Deductible, and only up to the applicable Allowed Amount or Maximum Allowable Payment.