What does “usual, customary and reasonable” (UCR) mean?
A. Those words refer to the charges and costs that are typical or standard for your region. Let’s say that the usual, customary and reasonable fee, based on an accurate study of doctors’ charges, for an anesthesiologist is $500. But he charges you $600, so your insurance will pay its percentage of the $500. You’ll pay anything above that percentage of the $500, plus your deductible.
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?
- Plans say they pay for Usual, Customary & Reasonable (UCR) or Reasonable & Customary (R&C) charges. What does UCR or R&C mean and how is it determined?
- When an insurance company denies part of a claim because of "usual, customary and reasonable" (UCR) allowances, is there an appeal process?
