Allowed Charge definition

Allowed Charge. An amount that is not more than the usual or customary charge for the service or supply as determined by Us, based on a standard which is most often charged for a given service by a Provider within the same geographic area .
Allowed Charge means an amount that is not more than the negotiated fee schedule. AMBULANCE. A certified transportation vehicle for transporting Ill or Injured people that contains all life-saving equipment and staff as required by applicable state and local law. AMBULATORY SURGICAL CENTER. A Facility mainly engaged in performing Outpatient Surgery. It must:
Allowed Charge means an amount that is not more than the negotiated fee schedule. AMBULANCE. A certified transportation vehicle for transporting Ill or Injured people that contains all life-saving equipment and staff as required by applicable state and local law. AMBULATORY SURGICAL CENTER. A Facility mainly engaged in performing Outpatient Surgery. It must: be staffed by Practitioners and Nurses, under the supervision of a Practitioner; have operating and recovery rooms; be staffed and equipped to give emergency care; and have written back-up arrangements with a local Hospital for emergency care. It must carry out its stated purpose under all relevant state and local laws and be either: accredited for its stated purpose by either The Joint Commission or the Accreditation Association for ambulatory care; or approved for its stated purpose by Medicare. A Facility is not an Ambulatory Surgical Center, for the purpose of this Contract, if it is part of a Hospital. ANNUAL OPEN ENROLLMENT PERIOD. The designated period of time each year during which: individuals are permitted to enroll in a standard health benefits plan or standard health benefits plan with rider; and individuals who already have coverage may replace current coverage with a different standard health benefits plans or standard health benefits plan with rider. [APPROVED CANCER CLINICAL TRIAL. A scientific study of a new therapy or intervention for the treatment, palliation, or prevention of cancer in human beings that meets the following requirements: The treatment or intervention is provided pursuant to an approved cancer clinical trial that has been authorized or approved by one of the following: 1) The National Institutes of Health (Phase I, II and III); (2) the United States Food and Drug Administration, in the form of an investigational new drug (IND) exemption (Phase I, II and III); 3) The United States Department of Defense; or 4) The United States Department of Veteran Affairs. The proposed therapy has been reviewed and approved by the applicable qualified Institutional Review Board. The available clinical or pre-clinical data to indicate that the treatment or intervention provided pursuant to the Approved Cancer Clinical Trial will be at least as effective as standard therapy, if such therapy exists, and is expected to constitute an improvement in effectiveness for treatment, prevention and palliation of cancer. The Facility and personnel providing the treatment are capable of doing so by virtue of thei...

Examples of Allowed Charge in a sentence

  • For charges that are not determined by a negotiated fee schedule, the [Member] may be billed for the difference between the Allowed Charge and the charge billed by the Provider.

  • Please note: The Coordination of Benefits and Services provision includes a distinct definition of Allowed Charge.] AMBULANCE.

  • An amount that is not more than the [lesser of: • the] allowance for the service or supply as determined by Us based on a standard approved by the Board[; or [• the negotiated fee schedule.] The Board will decide a standard for what is considered an Allowed Charge under this Contract.


More Definitions of Allowed Charge

Allowed Charge means an amount that is not more than the lesser of the allowance for the service or supply as determined by the standard approved by the Board as set forth at N.J.A.C. 11:21-7.13 or the negotiated fee schedule.
Allowed Charge means an amount that is not more than the negotiated fee schedule. AMBULANCE. A certified transportation vehicle for transporting Ill or Injured people that contains all life-saving equipment and staff as required by applicable state and local law. AMBULATORY SURGICAL CENTER. A Facility mainly engaged in performing Outpatient Surgery. It must: be staffed by Practitioners and Nurses, under the supervision of a Practitioner; have operating and recovery rooms; be staffed and equipped to give emergency care; and have written back-up arrangements with a local Hospital for emergency care. It must carry out its stated purpose under all relevant state and local laws and be either: accredited for its stated purpose by either The Joint Commission or the Accreditation Association for ambulatory care; or approved for its stated purpose by Medicare. A Facility is not an Ambulatory Surgical Center, for the purpose of this Contract, if it is part of a Hospital. ANNUAL OPEN ENROLLMENT PERIOD. The designated period of time each year during which: individuals are permitted to enroll in a standard health benefits plan ; and individuals who already have coverage may replace current coverage with a different standard health benefits plans. [APPROVED CANCER CLINICAL TRIAL. A scientific study of a new therapy or intervention for the treatment, palliation, or prevention of cancer in human beings that meets the following requirements: The treatment or intervention is provided pursuant to an approved cancer clinical trial that has been authorized or approved by one of the following: 1) The National Institutes of Health (Phase I, II and III); (2) the United States Food and Drug Administration, in the form of an investigational new drug (IND) exemption (Phase I, II and III); 3) The United States Department of Defense; or 4) The United States Department of Veteran Affairs. The proposed therapy has been reviewed and approved by the applicable qualified Institutional Review Board. The available clinical or pre-clinical data to indicate that the treatment or intervention provided pursuant to the Approved Cancer Clinical Trial will be at least as effective as standard therapy, if such therapy exists, and is expected to constitute an improvement in effectiveness for treatment, prevention and palliation of cancer. The Facility and personnel providing the treatment are capable of doing so by virtue of their experience and training The trial consists of a scientific plan of treatment that inc...

Related to Allowed Charge

  • Fixed Charge , in relation to a tenancy, means—

  • Monthly Charge shall have the meaning set forth in Article 5.

  • Disallowed costs means those charges determined to be unallowable, in accordance with the applicable Federal statutes, regulations, or the terms and conditions of the Federal award. (2 CFR 200.31 and 45 CFR 75.2)

  • Transition bond charge means a charge, expressed as an

  • Fixed Charges means, with respect to any specified Person for any period, the sum, without duplication, of:

  • Hire Charge or “Hire Charges” means the rates and charges payable by You for the hire of the Equipment.

  • Service Charge means the amount charged for making a service available on line and is in addition to the actual fee for a service itself. For example, one who renews a license on line will pay the license renewal fee and a service charge.

  • Administrative Charge means, with respect to any Lease, any payment (whether or not part of the fixed monthly payment) payable to the related Lessor representing a disposition fee, a late payment fee, an Extension Fee, an allocation to the related Lessee of insurance premiums, sales, personal property or excise taxes or any other similar charge.

  • User charge means a charge imposed on airlines for the provision of airport, air navigation, or aviation security facilities or services including related services and facilities.

  • Secured Tax Claim means any Secured Claim that, absent its secured status, would be entitled to priority in right of payment under section 507(a)(8) of the Bankruptcy Code (determined irrespective of time limitations), including any related Secured Claim for penalties.

  • Demand Charge means the charge, expressed in $/103m3/month for Firm Service except Seasonal Service or Daily Seasonal Service, in $/103m3/day for Seasonal Service, as specified in Schedule "A" to Shipper's Firm Transportation Service Agreement, and in $/103m3/day for Daily Seasonal Service, as specified in each Schedule "B-2" to Shipper's Firm Transportation Service Agreement.

  • Fixed Charge Ratio means, as of any date of determination, the quotient (expressed as a percentage) of (a) Consolidated EBITDA, divided by (b) Consolidated Fixed Charges.

  • Priority Tax Claims means Claims of governmental units of the kind specified in section 507(a)(8) of the Bankruptcy Code.

  • Rent and Charges Reserve means the aggregate of (a) all past due rent and other amounts owing by a Loan Party to any landlord, warehouseman, processor, repairman, mechanic, shipper, freight forwarder, broker or other Person who possesses any Collateral or could assert a Lien on any Collateral; and (b) a reserve equal to three months rent and other charges that could be payable to any such Person, unless it has executed a Collateral Access Agreement.

  • Floating Charge means a charge that, as created, was a floating charge;

  • Finance charge means that term as defined in section 106 of the truth in lending act, 15 USC 1605.

  • Consolidated Fixed Charges means, with respect to any Person for any period, the sum, without duplication, of: