Usual and Customary Fees definition

Usual and Customary Fees means the fees that may be billed to HCA for certain services, supplies, or equipment. These Fees may not exceed: (1) The Usual and Customary Fees xxxx to the general public for the same service, or (2) If the general public is not served, the Fee normally billed to other contractors for the same service.
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Usual and Customary Fees means those fees that the Participating Dentist usually charges its patients for dental services when a person is not affiliated with any dental program.
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Examples of Usual and Customary Fees in a sentence

  • Usual and Customary Fee - Usual and Customary Fees are calculated by the Company based on available data resources of competitive fees in that geographic area.

  • Usual and Customary Fees must not exceed the fees that the provider would charge any similarly situated payor for the same services.

  • Usual and Customary Fees are determined solely in accordance with the Company's reimbursement policy guidelines.

  • Typically, Coordination of Benefits will result in the following: If the other coverage is a group indemnity plan: • If the group indemnity coverage is primary, the provider will usually bill the carrier for their Usual and Customary Fees, and the member will be charged the copayment under the secondary plan less the amount received from the primary coverage.

  • Usual and Customary Fees are determined solely in accordance with the Company’s reimbursement policy guidelines.

  • Usual and Customary Fee - Usual and Customary Fees are calculated by the Company based on available data resources of competitive fees in that geographic area.Usual and Customary Fees must not exceed the fees that the provider would charge any similarly situated payor for the same services.

  • Usual and Customary Fees must not exceed the fees that the provider would charge any similarly situated payor for the same services.Usual and Customary Fees are determined solely in accordance with the Company's reimbursement policy guidelines.

  • Non-Network Benefits - benefits available for Covered Dental Services obtained from Non-Network Dentists.Usual and Customary Fee - Usual and Customary Fees are calculated by the Company based on available data resources of competitive fees in that geographic area.

  • The definition of Necessary used in this endorsement relates only to benefits under this endorsement and differs from the way in which a Dental Provider engaged in the practice of dentistry may define necessary.Usual and Customary Fee - Usual and Customary Fees are calculated by the Company based on available data resources of competitive fees in that geographic area.

  • Usual and Customary Fees are determined in accordance with the Company’s reimbursement policy guidelines.

Related to Usual and Customary Fees

  • 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.

  • 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 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.

  • Impact Fees means those fees imposed so that developments bear a proportionate share of the cost of public facilities and service improvements that are reasonably related to the impacts and burdens of the Project, adopted pursuant to Morgan Hill Municipal Code Chapter 3.56 and California Government Code Section 66001 et seq.

  • 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.

  • Basic generation service transition costs means the amount by

  • Medical Expenses means those expenses that an Insured Person has necessarily and actually incurred for medical treatment on account of Illness or Accident on the advice of a Medical Practitioner, as long as these are no more than would have been payable if the Insured Person had not been insured and no more than other hospitals or doctors in the same locality would have charged for the same medical treatment.

  • Processing Fees means all routine, generally applicable City-wide fees required by the City for processing applications and permits including, but not limited to, fees for land use applications, building applications, building permits, and certificates of occupancy.

  • Program Costs means all necessary and incidental costs of providing program services.