approved charge


Also found in: Financial.

approved charge

The money paid by Medicare (US) to a healthcare provider which it deems “reasonable and customary” for a particular covered medical service in a particular region, typically less than the actual charge.

approved charge

Health insurance The monies paid under Medicare as the maximum fee for a covered service
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If a doctor does not accept assignment (nonparticipating physician), Medicare pays the patient 80% of the approved charge, after subtracting any part of the annual deductible the patient has not paid.
A physician who includes charges for independent clinical laboratory services in his bill is entitled to the lesser of: (1) the approved charge of the laboratory,
In addition, appropriated funds are available to pay the "gross-up" fee assessed by the Potomac Electric Power Company (Pepco) because the "gross-up" fee represents the cost of additional income taxes to Pepco that Pepco is attempting to recover through a regulatory approved charge and is not a direct tax upon the federal government.
Copayment (also called coinsurance): That portion (usually 20 percent) of the approved charge for healthcare that must be paid by the patient--along with any deductible.
The prevailing-charge source includes services where the prevailing charge was equal to the approved charge and was less than both the customary and submitted charges.
Using 1986 data from the local Medicare Part B carrier, we were able to identify, for each Part B service, the approved charge for each specific service, test, procedure, and item of equipment.
The Contract Calculator returns the appropriate approved charge, deductible, and co-pay or coinsurance according to the payer's contracted rate; eliminates small balance write-offs; and simplifies compliance with PPACA's new "limitation on charges" rule.
In October, a federal grand jury approved charges on former Trump aides.
It would empower Nepra to establish district-level complaint offices to hear and decide on complaints regarding overbilling, non-compliance of instructions respecting metering and collection of approved charges, disconnection in case of non-payment of charges, electric power theft, and use of energy for purposes other than for which it was supplied.
The clause relates to 'offices of complaints regarding over-billing etc', the authority may establish district-level complaint offices to hear and decide complaints regarding over-billing, non-compliance of instruction respecting metering and collection of approved charges, disconnection in case of non-payment of charges, electric power theft and use of energy for purposes other than for which it was supplied'.
The HA's car park charges are reviewed annually and the approved charges will take effect from January 1 of the following year.
Presiding over the Board meeting to review administration matters, the meeting approved charges on those putting construction material on roads and streets, which hinders flow of traffic and irritates the residents.