|
Usual and customary
charges defined
-
Usual and customary
charges
are the basis for
conventional indemnity plans
which operates based on usual, customary, and
reasonable (UCR)
charges. UCR charges mean that the charge is the provider’s usual fee for a
service that does not exceed the customary fee in that geographic area, and is
reasonable based on the circumstances. Instead of UCR charges, PPO plans often
operate based on a negotiated (fixed) schedule of fees that recognize charges
for covered services up to a negotiated fixed dollar amount. |