Examples of Customary Charge in a sentence
Charges for an assistant surgeon are covered up to 20% of the Usual, Reasonable and Customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.
Where MetLife determines that there is inadequate charge information maintained in MetLife’s Reasonable and Customary Charge records for the geographic area in question, the Customary Charge will be determined based on actuarially sound principles.An example of how the 90th percentile is calculated is to assume one hundred (100) charges for the same service are contained in MetLife’s Reasonable and Customary charge records.
Covered Charge: The Reasonable and Customary charge incurred for a service or supply listed in this certificate which is performed or given under the direction of a Doctor for the Medically Necessary treatment of an Injury caused by an Accident.
Charges for an assistant surgeon are covered up to 20% of the Usual and Customary charge of the primary surgeon.
No more than the Reasonable and Customary charge less coinsurance will be considered by the Program for medically necessary covered services.