Reasonable & Customary charges definition

Reasonable & 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 of identical or similar services, taking into account the nature of the illness/injury involved.
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Reasonable & Customary charges means a charge which a) is charged for medical treatment of Illness or Injury, supplies or medical services that are medically necessary, as certified by the Medical Practitioner for the treatment of such Illness or Injury; b) do not exceed the level of charges that are charged on average basis, for similar medical treatment, supplies or medical services in the locality where the expenses are incurred when compared with comparable providers only ; and c) do not include charges that would not have been made if no insurance existed.
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Reasonable & Customary charges. The average amount charged in respect of valid services or treatment costs, as determined by our experience in any particular country, area or region and substantiated by an independent third party, being a practising surgeon/physician/specialist or government health department. Related Condition: Any injuries, illnesses or diseases are related conditions if we, on general advice, determine that one is a result of the other or if each is a result of the same injury, illness or disease.
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Examples of Reasonable & Customary charges in a sentence

  • Generic limit applies Orthotic/Orthopedic Custom-made orthotic inserts for shoes, prescribed by a doctor, chiropodists or podiatrist up to maximum of $350 per person per benefit year Paramedical Services Bundled at a combined maximum of $750/person per benefit year with 80% copayment (employee pays 20%) Reasonable & Customary Charges apply, specific credentials required.

  • Maximum: Private Applies to: Room and Board Reasonable & Customary Charges 180 days per disability Applies to: Convalescent Care Vision Vision Care including Visual Training and Laser Vision Correction and Laser Vision Correction Co-insurance: 80% of the first $1,000 of paid claims and 100% of the balance.

  • If, while covered under this provision, Individual Covered confined to a hospital as a resident inpatient for childbirth, this supplementary benefit will pay Reasonable & Customary Charges for all medically necessary treatment in connection with pre-natal and childbirth for the mother but only up to the limits stated in the Participant’s Specific Schedule, for normal delivery.

Related to Reasonable & 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.

  • Usual and Customary Charges means those comparable charges for similar treatment, services and supplies in the geographic area where treatment is performed.

  • 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.

  • 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;

  • Delivery charges means charges by the seller for preparation and delivery to a location designated by the purchaser of tangible personal property or services. Delivery charges include, but are not limited to, transportation, shipping, postage, handling, crating, and packing. Beginning September 1, 2004, delivery charges do not include the charges for delivery of direct mail if the charges are separately stated on an invoice or similar billing document given to the purchaser. If a shipment includes both exempt property and taxable property, the seller shall allocate the delivery charge using 1 of the following methods:

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

  • 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.

  • Monthly Charges means a finance carrying charge of one and one-half of one percent (1.5%) and a storage and handling charge of one-half of one percent (0.5%), in each case of the Cost of the Inventory and/or Special Inventory and/or of the fees for the Product affected by the reschedule or cancellation (as applicable) per month until such Inventory and/or Special Inventory and/or Product is returned to the vendor, used to manufacture Product or is otherwise purchased by Customer.

  • Service Charges means the fees levied by the municipality in terms of its tariff policy for any municipal services rendered in respect of an immovable property and includes any penalties, interest or surcharges levied or imposed in terms of this policy.

  • Carrying Costs With respect to any Payment Date, the sum of amounts payable under Section 2.7(a)(iv)(A)-(C).

  • Access Charges means the sum payable under the Access Agreement and/or this RAO agreed by the Operators to be paid by the Access Seeker to the Access Provider for providing the Access Service, the indicative Access Charges are as per Appendix C hereof which rate is exclusive of GST which shall be payable also by the Access Seeker.

  • Utility Charges means water, sewer, electricity, gas and other utility charges, if any, applicable to the Real Property or the Leased Real Property;

  • Usage Charges means the Charges for the Service or applicable part of the Service that are calculated by multiplying the volume of units that the Customer used or incurred in a period (e.g. number of users using the Service, or the number of minutes the Service was used for) with the relevant fee that is specified in the Online Order.

  • 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.

  • Routine Patient Costs means all health care services that are otherwise covered under the Group Contract for the treatment of cancer or other Life-threatening Condition that is typically covered for a patient who is not enrolled in an Approved Clinical Trial.

  • Approved costs means the eligible costs or expenditures2 as approved by the Provider, and as defined in the Agreement or Decision on Grant Funding to carry out the Grant Project.

  • 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.

  • Hire Charges means the rates and charges payable by You for the hire of the Equipment.

  • SLDC Charges means the charges levied by the SLDC of the state wherein the Solar Power Project is located;