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Plans say they pay for usual, customary, and reasonable (UCR) or reasonable and customary (R&C) charges. What does UCR and R&C mean and how is it determined?

April 26, 2017Charges customary mean pay plans reasonable UCR usual

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Plans say they pay for usual, customary, and reasonable (UCR) or reasonable and customary (R&C) charges. What does UCR and R&C mean and how is it determined?

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A. UCR and R&C are interchangeable terms. They refer to a method by which the insurance industry determines what most providers’ charge for a specific service in a specific area of the country. These standards are developed based on actual charges and are up-dated constantly based on current pricing.