Allowable Amount definition

Allowable Amount is defined in the EOC. In addition: • Coinsurance is calculated from the Allowable Amount or Benefit maximum, whichever is less.

Allowable Amount means the maximum amount determined by HMO to be eligible for consideration of payment for a particular Covered Drug. As applied to Participating Pharmacies the Allowable Amount is based on the provisions of the contract between HMO and the Participating Pharmacy in effect on the date of service. As applied to Prescription Drugs Purchased Outside of the Service Area, the Allowable Amount is based on the Participating Pharmacy contract rate.

Allowable Amount on any date, means:

Examples of Allowable Amount in a sentence

• BCBSTX has established an Allowable Amount for Medically Necessary services, supplies, and procedures provided by Providers that have contracted with BCBSTX or any other Blue Cross and/or Blue Shield Plan, and Providers that have not contracted with BCBSTX or any other Blue Cross and/or Blue Shield Plan.

• Review the definition of Allowable Amount in the DEFINITIONS section of this Benefit Booklet to understand the guidelines used by BCBSTX.

• Once you reach your Out-of-Pocket Maximum, the Claims Administrator will pay 100% of the Allowable Amount for Covered Services for the rest of the Calendar Year.Your payment after you reach the Calendar Year OOPM.

• Therefore, you will also pay all charges above the Allowable Amount.

• When you receive Covered Services from a Non-Participating Provider, you are responsible for:• the Copayment or Coinsurance (once any Calendar Year Deductible has been met), and• any charges above the Allowable Amount.

More Definitions of Allowable Amount

Allowable Amount the lesser of (i) the Borrowing Base less Availability Reserves and (ii) the Maximum Amount.

Allowable Amount on any date, means with respect to Eligible Securities, the aggregate principal amount of such Eligible Securities theretofore advanced thereon which remains unpaid on such date.

Allowable Amount means the maximum amount determined by HMO to be eligible for consideration of payment for a particular service, supply or procedure rendered by a Participating Provider. The Allowable Amount is based on the provisions of the Participating Provider contract and the payment methodology in effect on the date of service, whether diagnostic related grouping (DRG), capitation, relative value, fee schedule, per diem or other.

Allowable Amount means the maximum amount determined by Us to be eligible for consideration of payment for a particular service, supply or procedure.

Allowable Amount means, with respect to any Acceptable Obligor, such amount as may be specified on Schedule 1.2 hereto (as applicable) as the maximum aggregate exposure for such Acceptable Obligor (as modified from time to time in accordance with Section 2.20 hereof).

Allowable Amount means the lesser of the Borrowing Base and the Maximum Amount.

Allowable Amount means the maximum amount determined by HMO to be eligible for consideration of payment for a particular service, supply or procedure rendered by a Participating Provider. The Allowable Amount is based on the provisions of the Participating Provider contract and the payment methodology in effect on the date of service, whether diagnostic related grouping (DRG), capitation, relative value, fee schedule, per diem or other. Approved Clinical Trial means a phase I, phase II, phase III, or phase IV clinical trial that is conducted in relation to the prevention, detection, or treatment of cancer or other Life-Threatening Disease or Condition. The trial must be: