Reasonable and Customary Costs definition

Reasonable and Customary Costs means costs that are incurred for approved, covered medical services or supplies that do not exceed the standard fee of other providers of similar standing in the same geographical area, for the same treatment of a similar sickness and/or injury.
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Reasonable and Customary Costs means costs that are incurred for approved, eligible medical services or supplies that do not exceed the average reimbursement the provider receives for all services rendered to its patients, up to a maximum of one and a half times the rate that would be applicable if the costs were payable by US Medicare.
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Reasonable and Customary Costs has the meaning set forth in Section 4.5(f).
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Examples of Reasonable and Customary Costs in a sentence

  • Reasonable and Customary Costs: Costs incurred for approved, eligible treatment or supplies that do not exceed the standard costs of other providers of similar standing in the same region, for the same treatment of a similar Sickness or Injury.

  • In the event of an elected caesarean section, this policy excludes expenses relating to the caesarean section procedure, but will reimburse the Reasonable and Customary Costs for Hospital room and board charges (up to semi-private room accommodation), subject to the Maternity Benefit maximum.

  • Reasonable and Customary Costs — If you pay eligible expenses directly to a health service provider, these services will be reimbursed to you on the basis of the reasonable and customary costs that would have been paid directly to the provider by the Insurer.

  • The Insurer will reimburse the Reasonable and Customary Costs incurred for the prepara- tion and transportation of the remains of the deceased Insured Person to his/her residence in Canada or the Reasonable and Customary Costs of cremation or burial at the place of death.

  • If You incur any expenses without prior approval by Global Excel, such expenses will be covered, except where the Policy expressly requires the prior approval or authorization of Global Excel, on the basis of the Reasonable and Customary Costs that would have been payable for such expenses by the Insurer in accordance with the terms and conditions of the Policy.

  • When by reason of Injury or Sickness, an Insured Person incurs expenses for any of the following while under the regular care and attendance of a Physician or Surgeon, the Insurer will pay the Reasonable and Customary Costs incurred for the following: • Diagnostic, X-Ray, and Laboratory Services.

  • Such expenses may be higher than this amount, therefore You will be responsible for paying any difference between the amount You incur and the Reasonable and Customary Costs reimbursed by the Insurer.

  • Reasonable and Customary Costs — If you pay eligible expenses directly to a health service provider without prior approval by CAA Medical Assistance, these services will be reimbursed to you on the basis of the reasonable and customary costs that would have been paid directly to such provider by the Insurer.

  • If death occurs during the Coverage Period as a result of a covered Injury or Sickness, the Insurer will pay either (a) up to $12,500 towards the Reasonable and Customary Costs for the preparation and return of the Insured Person’s remains to the Insured Person’s Home Country in a standard transportation container or (b) up to $10,000 for the cost of preparing the remains, cremation or burial, and a burial plot in the location where death occurs.

  • R Reasonable and Customary Costs What customers would usually be charged for a specific service in a particular geographic area.


More Definitions of Reasonable and Customary Costs

Reasonable and Customary Costs means the costs of:
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Reasonable and Customary Costs means costs that are incurred for approved, covered medical services or supplies that do not exceed the standard fee of other providers of similar standin in the same eo raphical area, for the same treatment of a similar
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Reasonable and Customary Costs means costs that are incurred for approved, eligible medical services or supplies that do not exceed the average reimbursement the provider receives for all services rendered to its patients.
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Reasonable and Customary Costs means costs that are incurred forapproved, coveredmedical services orsuppliesthat do not exceed the standard fee of other providers of similar standing in the same geographical area, for the same treatment of a similar sickness and/or injury.
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Reasonable and Customary Costs means costs that are incurred forapproved, coveredmedicalservices or suppliesthat donot exceed the standard fee of other providers of similar standing in the same geographical area, for the same treatment of a similar sickness and/or injury.
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Reasonable and Customary Costs means the amount usually charged for treatment, services or supplies to provide an appropriate level of care given the severity of the Sickness or Injury being treated, in the geographical location where the treatment, services or supplies are being provided.
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Related to Reasonable and Customary Costs

  • 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 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 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.

  • Usual and Customary Charge means the average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided.

  • Usual and Customary (U&C) shall mean covered expenses which are identified by the Plan Administrator, taking into consideration the fee(s) which the Provider most frequently charges the majority of patients for the service or supply, the cost to the Provider for providing the services, the prevailing range of fees charged in the same “area” by Providers of similar training and experience for the service or supply, and the Medicare reimbursement rates. The term(s) “same geographic locale” and/or “area” shall be defined as a metropolitan area, county, or such greater area as is necessary to obtain a representative cross-section of Providers, persons or organizations rendering such treatment, services, or supplies for which a specific charge is made. To be Usual and Customary, fee(s) must be in compliance with generally accepted billing practices for unbundling or multiple procedures.

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

  • Reimbursable Costs means expenses incurred by the employee in the course of engaging in the planned learning activity and include registration, tuition and examination fees as well as textbooks/discs and applicable taxes. They may also include reasonable, incremental meal, accommodation and travel expenses.

  • 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.

  • Reasonable and Prudent Operator means a person seeking, in good faith, to perform its contractual obligations and, in so doing and in the general conduct of its undertaking, exercising that degree of skill, diligence, prudence and foresight which would reasonably and ordinarily be expected from a skilled and experienced operator complying with all applicable Legal Requirements engaged in the same type of undertaking in similar circumstances and conditions;

  • Operational Expenses means expenses of the clerk of court used to maintain the clerk's office and includes, but is not limited to, (i) computer support, maintenance, enhancements, upgrades, and replacements and office automation and information technology equipment, including software and conversion services; (ii) preserving, maintaining, and enhancing court records, including, but not limited to, the costs of repairs, maintenance, consulting services, service contracts, redaction of social security numbers from certain records, and system replacements or upgrades; and (iii) improving public access to records maintained by the clerk, including locating technology in an offsite facility for such purposes or for implementation of a disaster recovery plan.