What is the meaning of Usual, Customary and Reasonable?
Usual, Customary and Reasonable charges represent the average or most common amount charged by medical providers for a particular service, treatment, or supply in the same geographic area. Typically information on rates for procedures is compiled into a data bank and updated periodically. So when a claim is submitted for a plan with UC&R benefits, the insurance company before making the claim payment reviews the UC&R rate and double checks that hospitals and doctors are not billing excessively for the particular service or procedure.
Related Questions
- 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?
- How are usual, customary, and reasonable charges determined for out-of-network medical benefits?
- What are usual customary and reasonable charges?
