2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 84
Usual and Customary Charge (U&C) means, with respect to Non-Participating Providers, charges made for
medical or dental services or supplies essential to the care of the individual will be subject to a Usual and Customary
determination. Usual and Customary allowances are based on what is usually and customarily accepted as
payment for the same service within a geographical area. In determining whether charges are Usual and
Customary, consideration will be given to the nature and severity of the condition and any medical or dental
complications or unusual circumstances which require additional time, skill or experience. Limitations for Usual and
Customary Charges are not applicable to Participating Providers, or to Non-Participating Providers for Medical
Emergency services, including Hospital emergency room treatment and emergency ambulance transportation or
for services provided by a Non-Participating Provider at a Network facility.
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