When it comes to determining the reasonable charges for past or future medical care, one important part is estimating the reasonable charge for prescription medications. RPC began using the Amazon Pricing method for all reviews of eligible past pharmacy bills effective September 14, 2023, the publication date of this white paper. Learn more about the Amazon pricing method and the difference between Amazon and the survey method.

The issue of whether a healthcare service's charges are reasonable arises when a healthcare provider and payor have not agreed on a negotiated payment rate for a service. Reasonableness of healthcare charges are at issue in some personal injury cases as well as commercial litigation and can effect the economic damages in the case. [...]

This whitepaper focuses on damages a plaintiff can recover for past medical expenses in personal injury cases in Texas courts. We note damages for future medical expenses raise different issues and that discussion is outside the scope of this paper.

Oil and natural gas prices are volatile. Changes in those prices drives changes in employment and wages for workers in jobs related to exploration, development and production (EDP). Because of the danger in some EDP jobs, these workers may be plaintiffs in personal injury and wrongful death cases. Computing damages for loss of earning capacity [...]

The question of whether a provider’s charges are reasonable arises when there is no provider contract or government regulation setting the rate for a service (e.g., out-of-network providers in health plans, personal injury cases, first-person auto claims), and when the third-party payor sets the allowed amount based on the Usual, Customary, and Reasonable (“UCR”) charge [...]