Recognized Charge definition

Recognized Charge means the negotiated charge contained in an agreement the claims administrator has with the provider either directly or through a third party. If there is no such agreement, the Recognized Charge is determined in accordance with the provisions of this section.
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Recognized Charge is defined in GovGuam’s Plan. Where a similar term (such as “reasonable charge amount”) is used in GovGuam’s Plan instead of “recognized charge”, it will have the same meaning as Recognized Charge.
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Recognized Charge means the negotiated charge contained in an agreement the claims administrator has with the provider either directly or through a third party. If there is no such agreement, the recognized charge is determined in accordance with the provisions of this section. An out-of-network provider has the right to bill the difference between the recognized charge and the actual charge. This difference will be the covered person's responsibility.
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Examples of Recognized Charge in a sentence

  • Recognized Charge (RC) is a charge which is not higher than the usual charge made by the provider of the care or supply and does not exceed the usual charge made by most providers of like service in the same area.

  • The Plan will reimburse the actual charge billed if it is less than the Recognized Charge.

  • Extreme EmergenciesIn an extreme emergency, call 911 or go to the nearest hospital emergency room.For emergency medical services or urgent care services, the Plan will pay the greater of the Recognized Charge or the charge, had the services been received from a network health care provider.If you require hospitalization following emergency medical services, you or a family member must notify the Scripps Medical Plan Member Service Center at 1-877-552-7247 as soon as it is reasonably possible.

  • Charges for multiple surgical procedures will be a Covered Charge subject to the following provisions: (a) If bilateral or multiple surgical procedures are performed by one (1) surgeon, benefits will be determined based on the Recognized Charge that is allowed for the primary procedures; 50% of the Recognized Charge will be allowed for each additional procedure performed through the same incision.

  • Any procedure that would not be an integral part of the primary procedure or is unrelated to the diagnosis will be considered "incidental" and no benefits will be provided for such procedures; (b) If multiple unrelated surgical procedures are performed by two (2) or more surgeons on separate operative fields, benefits will be based on the Recognized Charge for each surgeon's primary procedure.

  • Benefits for medically necessary and appropriate authorized referral services received from a non-network provider will be payable as shown in the SCHEDULES FOR NON-NETWORK PROVIDERS (benefits will be reimbursed based on Recognized Charge).

  • Percentages of remaining charges you pay are based on Negotiated Charges in network and Recognized Charges out of network.A provider outside the network may require that you pay more than the Recognized Charge, and this additional amount would be your responsibility.For a full description of covered services and exclusions, please see the Certificate and Booklet Summary of Coverage (SOC) available online at www.AllegisMarketplace.com.

  • For High Deductible, Low Deductible and Catastrophic Medical, the total benefits paid by Dow may not exceed the Negotiated Charge (for Services received through an In-Network Provider) or the Recognized Charge (for Services received through an Out-of-Network Provider or Out-of-Area).

  • Pursuant to the language in the Information Booklet, payments made by the plan for medical services are based on the Recognized Charge.15 There are four different ways of calculating the Recognized Charge.

Related to Recognized Charge

  • Transition bond charge means a charge, expressed as an

  • Fixed Charge , in relation to a tenancy, means—

  • Service Charge means the amount charged for making a service available on line and is in addition to the actual fee for a service itself. For example, one who renews a license on line will pay the license renewal fee and a service charge.

  • Float means the stored value remaining on an Octopus, excluding SVF Deposit;

  • Net earnings available for fixed charges means net income after deducting operating and maintenance expenses, taxes other than federal and state income taxes, depreciation, and depletion, but excluding extraordinary expenses appearing in the regular financial statements of the system.

  • External floating roof means a storage vessel cover in an open tank top consisting of a double deck or pontoon single deck which rests upon and is supported by the petroleum liquid being contained and is equipped with a closure seal or seals to close the space between the roof edge and tank shell.

  • Annual Service Charge as of any date means the amount which is expensed in any 12-month period for interest on Debt of the Issuer and its Subsidiaries.

  • 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.

  • Internal floating roof means a cover or roof in a fixed-roof tank that rests upon or is floated upon, the liquid being contained, and is equipped with a closure seal or seals to close the space between the roof edge and the tank shell.

  • Fixed Charges means, with respect to any specified Person for any period, the sum, without duplication, of:

  • Hearing examiner means the labor commissioner or the commissioner’s designee.

  • Annual Debt Service Charge as of any date means the amount which is expensed in any 12-month period for interest on Debt of the Company and its Subsidiaries.

  • Room charge means the charge imposed for the use or occupancy of a room, excluding charges for food, beverages, state use tax, telephone service, or like services paid in connection with the charge, and excluding reimbursement of the assessment imposed by this act.

  • Debt Service Charges means for any Measurement Period, the sum of (a) Consolidated Interest Charges paid or required to be paid for such Measurement Period, plus (b) principal payments made or required to be made on account of Indebtedness (excluding the Obligations and any Synthetic Lease Obligations but including, without limitation, Capital Lease Obligations) for such Measurement Period, in each case determined on a Consolidated basis in accordance with GAAP.

  • Demand Charge means the charge, expressed in $/103m3/month for Firm Service except Seasonal Service or Daily Seasonal Service, in $/103m3/day for Seasonal Service, as specified in Schedule "A" to Shipper's Firm Transportation Service Agreement, and in $/103m3/day for Daily Seasonal Service, as specified in each Schedule "B-2" to Shipper's Firm Transportation Service Agreement.

  • Consolidated Fixed Charges means, with respect to any Person for any period, the sum, without duplication, of:

  • Maintenance Adder means an adder that may be included to account for variable operation and maintenance expenses in a Market Seller’s Fuel Cost Policy. The Maintenance Adder is calculated in accordance with the applicable provisions of PJM Manual 15, and may only include expenses incurred as a result of electric production.

  • Monthly Charge shall have the meaning set forth in Article 5.

  • No Charge Bid When Bids are requested on a number of Products as a Group or Lot, a Bidder desiring to Bid “no charge” on a Product in the Group or Lot must clearly indicate such. Otherwise, such Bid may be considered incomplete and be rejected, in whole or in part, at the discretion of the Commissioner.

  • Failed Bank Charge-Offs/Write-Downs means, with respect to any Shared- Loss Asset, an amount equal to the aggregate amount of reversals or charge-offs of Accrued Interest and charge-offs and write-downs of principal effected by the Failed Bank with respect to that Shared-Loss Asset as reflected on the Accounting Records of the Failed Bank.

  • Adviser Charge : means the fee agreed with your financial adviser in remuneration for the personal recommendation received prior to submission of an Application Form.

  • Account Charge means, in relation to each of the Charged Accounts, the first priority fixed charge or pledge over all such accounts given or to be given by the relevant account holder thereof in favor of and in form and substance satisfactory to the Security Trustee.

  • Total Service Charges means all charges, after application of all discounts and credits, incurred by Customer for Services provided under this Agreement, excluding Taxes, Governmental Charges, equipment, Company ILEC, Company Wireless, Document Delivery Fax, non-recurring, goods and services acquired by Company as Customer’s agent, international access that is passed-through (Type 3/PTT) or provided by Company (Type 1), charges for security services provided by a Cybertrust Security Service Provider listed in the Guide, and other charges expressly excluded by this Agreement.

  • FIXED CHARGE PER MONTH means the fixed charge per month payable by company which is inclusive of depreciation, parking fee if applicable, all applicable taxes & duties including VAT, insurances, wages and other emoluments of Operator/Driver(s) / Helper(s) /Jugalees and other operation staff/crew excluding GST.

  • Consolidated Non-cash Charges means, with respect to any Person, for any period, the aggregate depreciation, amortization and other non-cash expenses of such Person and its Restricted Subsidiaries reducing Consolidated Net Income of such Person and its Restricted Subsidiaries for such period, determined on a consolidated basis in accordance with GAAP (excluding any such charges constituting an extraordinary item or loss or any such charge which requires an accrual of or a reserve for cash charges for any future period).

  • Pharmacist-in-charge means a pharmacist currently licensed in good standing who accepts responsibility for the operation of a pharmacy in conformance with all laws and rules pertinent to the practice of pharmacy and the distribution of drugs, and who is personally in full and actual charge of the pharmacy and all personnel.