Health Insurance Usual and Customary Charges


 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.