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A medical charges is "usual and customary" (UC) when it is the same or similar amount for the same or similar service in the same or similar geographic area by the same or similar medical providers. If 100 surgeons charge $5,000.00 to perform the same surgery in a close geographic area then the "usual and customary" charge is $5,000.00. If 100 surgeons charge between $4,500 and $5,500.00 for the same surgery in the same area then the range of usual & customary is $4,500 to $5,500 and the average UC is $5,000.00 If a hundred taxi drivers charge $75.00 for the same trip between an airport and a downtown location then the "usual and customary" charge is $75.00. Yeah, it's that simple. "Reasonable" is best left out of the discussion because it's an impossible word to define. What's reasonable to one person may be totally unreasonable to another person. Note that UC is unrelated to the amount which an insurance company says is UC. The UC is not "set" by the insurance company or companies because the charge remains the same regardless of how much is paid. An insurance company may set an allowance amount which it then tries to retro-define as "usual & customary" but this is grossly inaccurate and used because it is self-serving to the insurance company. Best - LRL
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How can you find the reasonable and customary charges for psychotherapy in zip code 10021?
The Usual Customary and Reasonable charge for psychotherapy fee in New York, New York differs with each insurance provider. Contact your health insurer the psychotherapy visit price in New York.
What does customary system?
When relating to insurance payments, customary and usual are average charges for a certain procedure. For instance, if it is customary and usual for a doctor to charge $1,000 for a medical procedure, that is what the insurance payment is based on. It does not matter if the doctor charges more than that amount.
When determining professional fees what three VALUES are considered?
usual,customary,reasonable
How can you find the reasonable and customary charges for hernia repair outpatient?
To find the reasonable and customary charges for hernia repair, you need to find a state hospital or facility. State facilities tend to be cheaper than private facilities.
Where to find health insurance company with reasonable rates?
There are quite a few out there. The place to look is the website http://www.wecompareinsurance.com/articleinfo/usual-customary-and-reasonable-rates-and-health-insurance/81
What word means the same as normal?
Common, usual, typical, unexceptional, customary, general, ordinary, sane, rational, reasonable, well-adjusted, cool...
What is the synonym of customary?
Habitual. Usual. Regular.
What is the Synonym for Customary?
Usual, regular, typical
What is the limit that is placed on the amount that will be reimbursed for a particular service or procedure called?
Generally it's "negotiated rate." Check your policy for the definition. The other common definition is UCR, Usual,Reasonable and Customary.
What is customary dose for certain body weight called?
Usual dose is the term refers to " customary dose for body weight." so Answer to Q. : it is called "Usual dose."
What are some synonyms of usual?
customary, common, standard, natural, typical. accustomedare the synonyms of usual
What does usual?
1. Habitually or commonly occurring or done; customary
