Necessary and Reasonable Charges definition

Necessary and Reasonable Charges means the charges incurred for Medical Treatment and imposed by a Hospital or a Medical Practitioner which is appropriate, consistent with the accepted medical standards and could not have been omitted without adversely affecting a person’s medical condition. The charges must not exceed the general level of the charges of other Hospitals or Medical Practitioners providing the same Medical Treatment.
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Examples of Necessary and Reasonable Charges in a sentence

  • If two or more procedures were performed during one single operation through the same incision, the amount payable may not exceed the Necessary and Reasonable Charges incurred for the procedure which cost more.

  • Pre-Hospitalisation Diagnostic X-Ray and Laboratory Tests – If the Insured Member underwent diagnostic x-ray and laboratory tests as recommended by a Medical Practitioner or Specialist, we will pay the Necessary and Reasonable Charges incurred, provided that Hospitalisation or surgical procedure took place within 90 days of the x-ray or laboratory tests.

  • In-Hospital Physician’s Visits – If the Insured Member was treated by a Medical Practitioner or Specialist during the Hospitalisation for Illness or Injury which was caused solely and directly by an Accident, The Company will pay the Necessary and Reasonable Charges incurred for the In-Hospital Doctor’s Visit.

  • Los Angeles Unified School District Review Your Benefits: Maximum Benefits Paid As Specified BelowMedically Necessary and Reasonable Charges are based on the 75th percentile.-ACCIDENT ONLY COVERAGE: The Policy provides benefits for loss due to a covered Injury up to the Maximum Benefit as shown below for each Injury.

  • Covered Expenses means the Medically Necessary and Reasonable Charges for services, supplies, and treatment provided or prescribed by a Physician for which an Insured Person is required to pay.

  • Maximum Benefits Paid As Specified BelowMedically Necessary and Reasonable Charges are based on the 75th percentile.-ACCIDENT ONLY COVERAGE: The Policy provides benefits for loss due to a covered Injury up to the Maximum Benefit as shown below for each Injury.

  • Medically Necessary and Reasonable Charges are based on the 75th percentile.

  • An amount equal to the Necessary and Reasonable Charges made by the Hospital, payable only if the care is provided within seven (7) days from Hospital discharge subject to a minimum of three (3) days Hospitalization.

  • Describe the process that will be used to transfer the active caseloads of enrollees currently receiving Care Management from the MCE and/or other Subcontractor to the new Subcontractor.

  • The Necessary and Reasonable Charges incurred in respect of a miscarriage or an ectopic pregnancy will be paid.

Related to Necessary and Reasonable Charges

  • Reasonable Costs means the reasonable actual costs and expenses incurred by us in carrying out any further Audit under this Contract, including, but not limited to, reasonable travel and subsistence costs;

  • Reasonable pupil means a pupil, including, but not limited to, an exceptional needs pupil, who exercises average care, skill, and judgment in conduct for a person of his or her age, or for a person of his or her age with his or her exceptional needs.

  • Reasonable compensation means, with respect to a regularly employed officer or employee of any person, compensation that is consistent with the normal compensation for such officer or employee for work that is not furnished to, not funded by, or not furnished in cooperation with the Federal Government.

  • fair and reasonable conditions means appropriate conditions, including possible financial terms or royalty-free conditions, taking into account the specific circumstances of the request for access, for example the actual or potential value of the results or background to which access is requested and/or the scope, duration or other characteristics of the exploitation envisaged;

  • Reasonable cost means a cost for a service or item that is consistent with the market standards for comparable services or items.

  • necessary skills means skills and experience, other than professional qualifications, specified by the Corporation as appropriate for members to have;

  • Reasonable and Customary Charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the illness / injury involved.

  • Reasonable Steps means those steps the Receiving Party takes to protect its own similar proprietary and confidential information, which must not be less than a reasonable standard of care.

  • Reasonable Distance means a distance that has regard to the Employee’s original work location, current home address, capacity of the Employee to travel, additional travelling time, effects on the personal circumstances of the affected Employee, including family commitments and responsibilities and other matters raised by the Employee, or assistance provided by their Employer.

  • Reasonable grounds means that a reasonable person in your position would also suspect the information indicates misconduct or a breach of the law.

  • Reasonable Expenses means the reasonable expenses of Employees or Personnel, as the case may be, for which those Employees or Personnel may be reimbursed under the Operator’s usual expense account practice, as accepted by the Management Committee; including without limiting generality, any relocation expenses necessarily incurred in order to properly staff the Mining Operations if the relocation is approved by the Management Committee.

  • Necessary Action means, with respect to a specified result, all actions necessary to cause such result, including (i) voting or providing a written consent or proxy with respect to the Common Stock, (ii) causing the adoption of stockholders’ resolutions and amendments to the organizational documents of the Company, (iii) executing agreements and instruments, and (iv) making, or causing to be made, with governmental, administrative or regulatory authorities, all filings, registrations or similar actions that are required to achieve such result.

  • reasonable possibility means that there is a cause and effect relationship between the investigational product, study device and/or study procedure and the AE.

  • Reasonable suspicion means a basis for forming a belief based on specific facts and rational inferences drawn from those facts.

  • Reasonable in the circumstances means using no more force than is needed.

  • Reasonable Care means the use of reasonable custodial practices under the applicable circumstances as measured by the custodial practices then prevailing in Russia of International Financial Institutions acting as custodians for their institutional investor clients in Russia.

  • Reasonable Additional Expenses means expenses for meals, taxi fares, essential telephone calls, local transportation, and lodging which are necessarily incurred as the result of Trip Delay and which are not provided by the Common Carrier or any other party free of charge.

  • Reasonable and Customary means, in relation to a charge for Medical Service, such level which does not exceed the general range of charges being charged by the relevant service providers in the locality where the charge is incurred for similar treatment, services or supplies to individuals with similar conditions, e.g. of the same sex and similar Age, for a similar Disability, as reasonably determined by the Company in utmost good faith. The Reasonable and Customary charges shall not in any event exceed the actual charges incurred.

  • Reasonable payment means, with respect to professional and other technical services, a payment in an amount that is consistent with the amount normally paid for such services in the private sector.

  • Reasonable inquiry means an inquiry designed to uncover any information in the entity's possession about the identity of the producer or provider of covered telecommunications equipment or services used by the entity that excludes the need to include an internal or third-party audit.

  • Reasonable person means a reasonable person under similar circumstances and with similar identities to the victim.

  • Necessary Claims means claims of any patent or patent application, other than design patents and design registrations, in any jurisdiction in the world: (a) for which a GAIN POC Member has the right, at any time when this Policy is effective, to grant licenses or rights of the nature granted herein without such grant resulting in payment of royalties or other consideration to third parties (except for payments to Related Entities or employees); and (b) that are necessarily infringed by Compliant Portions of a particular Implementation. A claim is necessarily infringed hereunder only when such infringement could not have been avoided by another commercially reasonable non- infringing implementation of Compliant Portion(s) of that particular Implementation based on the state of the art when the applicable Final Specification is/was deemed final (or when the Implementers Draft was approved, as applicable), in accordance with the applicable OpenID Process. “Necessary Claims” do not, however, include any claims of any patent or patent application that read on: (x) any enabling technologies that may be necessary to make or use any product or service (or portion of either) that complies with an Implementers Draft or Final Specification, but that are not themselves expressly set forth in such Implementers Draft or Final Specification; (y) the implementation of other published standards not developed by or for the OpenID Foundation; or (z) any portion(s) of any product or service (or any combination of such portion(s)) the sole purpose or function of which is not required to comply with an Implementers Draft or Final Specification.;

  • Reasonable access for the purposes of this section means:

  • Reasonable Best Efforts means best efforts, to the extent commercially reasonable.

  • Takaful means a scheme based on brotherhood, solidarity and mutual assistance which provides for mutual financial aid and assistance to the Takaful Participants in case of need whereby the Takaful Participants mutually agree to contribute for that purpose.

  • Reasonable in these circumstances means ‘using no more force than is needed’. The use of force may involve either passive physical contact, such as standing between pupils or blocking a pupil’s path, or active physical contact such as leading a pupil by the arm out of the classroom. Departmental advice for schools is available here