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 Charge means the amount that the provider charges for the service or procedure in the majority of non-Medicaid cases. If the provider varies the charges so that no one amount is charged in the majority of cases, “usual and customary charge” means the median charge. Token charges for charity patients and other exceptional charges shall be excluded when calculating the usual and customary charge; and
Usual and Customary Charge means the amount we determine represents a customary charge for medical services in the geograhic area in which the service is rendered. We shall determine the usual and customary charge through the use of independent sources of our choice.
Examples of Usual and Customary Charge in a sentence
For purposes of this paragraph, Usual and Customary Charge means the amount that the participating pharmacy would have charged You if You were a cash paying customer.
Expenses in excess of the Usual and Customary Charge will not be considered eligible.
The Co-payment amount or Co-insurance percentage you pay for a Prescription Drug Product will not exceed the Usual and Customary Charge of the Prescription Drug Product.
Your Cost-Sharing will never exceed the Usual and Customary Charge of the Prescription Drug.
Any such payment shall not exceed the hospital’s Usual and Customary Charge.
More Definitions of Usual and Customary Charge
Usual and Customary Charge means the amount charged to other persons for the same service.
Usual and Customary Charge means an amount that we determine, through the use of independent sources of our choice, represents a customary charge for services in the geographical area in which the service is rendered.
Usual and Customary Charge means the amount a provider offers to charge the general public for a service or supply, including applicable offered discounts. General public does not include individuals who are enrolled in or a member of an insurance plan that covers the services or supplies in question, or receive a discount of the services or supplies through a program with selective criteria that disqualify certain individuals from eligibility in the program.
Usual and Customary Charge means the average amount charged by most providers for treatment, service or
Usual and Customary Charge means the fees, costs or charges we determine that represents a common and typical charge for services in the geographical area in which the service is rendered. We may determine the usual and customary charge by using independent sources of our choice.EXCLUSIONSPLEASE READ THE EXCLUSIONS CAREFULLY. IF ANY EXCLUSION APPLIES, COVERAGE WILL NOT BE PROVIDED FOR AN ACCIDENT OR LOSS THAT OTHERWISE WOULD BE COVERED UNDER THIS POLICY.A. We do not provide Medical Payments Coverage for any person for bodily injury:
Usual and Customary Charge means the charge most often made by providers of similar training, experience and licensure for a specific treatment, accommodation, product or service in the geographic area where the treatment, accommodation, product or service is provided.
Usual and Customary Charge means the fees, costs or charges we determine that represents a common and typical charge for services in the geographical area in which the service is rendered. We may determine the usual and customary charge by using independent sources of our choice.
A. We do not provide Medical Payments Coverage for any person for bodily injury:
1. Caused intentionally by, or at the direction of, an insured or that is, or should be, reasonably expected to result from an intentional act of an insured even if the actual bodily injury that results is different than that which was intended.
2. Arising out of, and in the course of, employment if worker’s compensation benefits, disability benefits or similar benefits are required or available for the bodily injury.
3. Arising out of the ownership, maintenance or use of a vehicle while it is being used to carry persons or property for compensation or a fee or as a public or livery conveyance. This exclusion does not apply to a share-the-expense car pool.
4. That occurs while the insured is employed or otherwise engaged in any motor vehicle business. However, this exclusion does not apply to the ownership, maintenance or use of a covered auto by you or a family member.