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What are “reasonable & customary charges”?

April 26, 2017customary

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What are “reasonable & customary charges”?

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Reasonable & customary charges are the accepted charges for specific medical procedures as determined by Aetna and Empire. This applies only when using out-of-network services. Meaning, if you choose to go to an out-of-network physician, he/she can charge you whatever he/she wants for medical services. If Aetna or Empire believes the physician charges more than their “reasonable & customary charges” you are responsible for paying the additional amount out of your own pocket.