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2/11/2022· Healthcare Facilities - Hospitals

Determining Usual, Customary, And Reasonable Charges For Healthcare Services

By: Research and Planning Consultants

This paper identifies and discusses industry standards for what charge percentile threshold state laws and private health plans consider reasonable to determine allowable amounts for payment. The term &"allowable amount"; refers to the total amount a regulation or private health plan determines a provider should be paid. It is the sum of the payment responsibilities of the plan and the patient.

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