Examples of Customary Fee in a sentence
The actual charge made by a non-Network Dental Provider for a Covered Dental Service may exceed the Usual and Customary Fee.
Non-Network Benefits are determined based on the Usual and Customary Fee for similarly situated Network Dental Providers for each Covered Dental Service.
Usual and Customary Fee - Usual and Customary Fees are calculated by the Company based on available data resources of competitive fees in that geographic area.
As a result, Insured Persons may be required to pay a non-Network Dental Provider an amount for a Covered Dental Service in excess of the Usual and Customary Fee.
As a result, an Insured Person may be required to pay a non-Network Dental Provider an amount for a Covered Dental Service in excess of the Usual and Customary Fee.
If a service is not listed below, it may be available at the Participating Dental Pro- vider's Usual and Customary Fee, less a discount of 25%.
Usual and Customary Fee - Usual and Customary Fees are calculated by the Company based on available data resources of competitive fees in that geographic area.Usual and Customary Fees must not exceed the fees that the provider would charge any similarly situated payor for the same services.
Insured Persons may be required to pay a non-Network Dental Provider an amount for a Covered Dental Service in excess of the Usual and Customary Fee.
Copayment and/or Coinsurance Amount For Prescription Drug Products at a retail Network Pharmacy, Insured Persons are responsible for paying the lowest of:• The applicable Copayment and/or Coinsurance.• The Network Pharmacy’s Usual and Customary Fee for the Prescription Drug Product.• The Prescription Drug Charge for that Prescription Drug Product.
Customary Fee: the fee level determined by the administrator of the dental benefit plan from actual submitted fees for a specific dental procedure to establish the maximum benefit payable under a given plan for that specific procedure.