Contracted Fee definition
Examples of Contracted Fee in a sentence
Payment for covered services performed by a Premier Provider is based on the Maximum Contract Allowance, and the Enrollee may be balance billed up to the Premier Provider’s Contracted Fee.
Dental Out-of-Pocket Maximum means the maximum amount that a Member will pay during a Calendar Year for Pediatric dental Benefits from a PPO Provider before Delta Dental begins to pay 100% of the PPO Contracted Fee.
Services received from Premier or Non-Delta Dental Providers may be subject to fees in excess of the Contracted Fee, as described in Part XVIII.
Services received from Premier or Non-Delta Dental Providers may be subject to fees in excess of the Contracted Fee, as described in P art XVIII.
PPO Providers have agreed to accept the Delta Dental PPO Contracted Fee for covered services.
Premier Providers may balance bill for the difference between the Delta Dental Premier Contracted Fee and the Delta Dental PPO Contracted Fee.
These charges are generally Your share of the Allowed Amount, as well as any Deductibles, charges where the maximum has been exceeded, charges for non-covered services and/or balance billing amounts over the Delta Dental PPO Contracted Fee.
Delta Dental PPO Provider (“PPO Provider”): A Provider who contracts with Delta Dental or any other member company of the Delta Dental Plans Association and agrees to accept the Delta Dental PPO Contracted Fee as payment in full for services provided under a PPO plan.
Delta Dental Premier Provider (“Premier Provider”): A Provider who contracts with Delta Dental or any other member company of the Delta Dental Plans Association and agrees to accept the Delta Dental Premier Contracted Fee as payment in full for services provided under a plan.
Dental Out-of-Pocket Maximum means the maximum amount that a Member will pay during a calendar year for pediatric dental benefits from a PPO Provider before Delta Dental begins to pay 100% of the PPO Contracted Fee.