Reasonable and Customary Charges definition

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 and Customary Charges means expenses which:

Reasonable and Customary Charges means an expense which:

Examples of Reasonable and Customary Charges in a sentence

• WorldCare has been designed to provide cover for Reasonable and Customary Charges for Medically Necessary and active Treatment of disease, illness or injury.

• If Treatment is Medically Necessary, but You did not obtain Pre-Authorisation, We will only pay up to Reasonable and Customary Charges.

• By Reasonable and Customary Charges We mean the standard fee that would be typically made in respect of Your Treatment.In the case of any Emergency, You, the treating Medical Practitioner or the Hospital, must contact Our 24 hour Emergency assistance service as soon as possible.

• WorldCare has been designed to provide cover for Reasonable and Customary Charges for Medically Necessary and active Treatment of disease, illness or injury.WorldCare provides worldwide cover, excluding the USA, unless the USA elective Treatment option is selected.

• When You should contact Us before Treatment starts.Your Group Plan with Us will only cover Reasonable and Customary Charges for Treatment thatis Medically Necessary.

More Definitions of Reasonable and Customary Charges

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 and Customary Charges means charges based

Reasonable and Customary Charges means charges for medical care which is medically necessary shall be considered reasonable and customary to the extent that it does not exceed the general level of charges being made by others of similar standing in the locality where the charge is incurred, when furnishing like or comparable treatment, services or supplies to individual of the same sex and of comparable age for a similar sickness, disease or injury and in accordance with accepted medical standards and practice could not have been omitted without adversely affecting the Insured Person’s medical condition.

Reasonable and Customary Charges means charges based upon the 90th percentile of the usual, customary, and reasonable (UCR) fee schedule determined by the Health Insurance Association of America or a similar nationally recognized database of prevailing health care charges.

Reasonable and Customary Charges means usual amount charged for treatment, supplies or medical services in the locality where such expense is incurred and does not include charges that would not have been made if no insurance existed.

Reasonable and Customary Charges means charges commonly used by Physicians in the locality in which care is furnished.

Reasonable and Customary Charges means charges that are, as determined by Us, comparable to other charges for the same service and level of expertise in the place where the Emergency took place.