{"id":82018,"date":"2021-02-10T06:59:33","date_gmt":"2021-02-10T06:59:33","guid":{"rendered":"https:\/\/www.healthbenefitstimes.com\/glossary\/?p=82018"},"modified":"2021-02-10T06:59:33","modified_gmt":"2021-02-10T06:59:33","slug":"usual-customary-and-reasonable-plans","status":"publish","type":"post","link":"https:\/\/www.healthbenefitstimes.com\/glossary\/usual-customary-and-reasonable-plans\/","title":{"rendered":"Usual, customary and reasonable plans"},"content":{"rendered":"

Health insurance plans that pay a physician’s full charge if: it does not exceed his usual charge; it does not exceed the amount customarily charged for the service by other physicians in the area (often defined as the 90 or 95 percentile of all charges in the community, or it is otherwise reasonable. In this context, usual and customary charges are similar, but not identical, to customary and prevailing charges, respectively, under Medicare. Most private health insurance plans, except for a few Blue Shield plans, use the UCR approach.<\/p>\n

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Health insurance plans that pay a physician’s full charge if: it does not exceed his usual charge; it does not exceed the amount customarily charged for the service by other physicians in the area (often defined as the 90 or 95 percentile of all charges in the community, or it is otherwise reasonable. In this […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[],"class_list":["post-82018","post","type-post","status-publish","format-standard","hentry","category-u"],"yoast_head":"\nUsual, customary and reasonable plans - Definition of Usual, customary and reasonable plans<\/title>\n<meta name=\"description\" content=\"Health insurance plans that pay a physician's full charge if: it does not exceed his usual charge; it does not exceed the amount customarily charged for the service by other physicians in the area (often defined as the 90 or 95 percentile of all charges in the community, or it is otherwise reasonable. In this context, usual and customary charges are similar, but not identical, to customary and prevailing charges, respectively, under Medicare. 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