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Reasonable and Customary Fees
The
average fee charged by a particular type of health
care practitioner within a geographic area. The
term is often used by medical plans as the amount
of money they will approve for a specific test or
procedure. If the fees are higher than the approved
amount, the individual receiving the service is
responsible for paying the difference. Sometimes,
however, if an individual questions his or her physician
about the fee, the provider will reduce the charge
to the amount that the insurance company has defined
as reasonable and customary. |
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