A reasonable and customary fee is the amount that your health plan determines is the normal range of payment for a specific health-related service or medical procedure within a given geographic area. If the charges submitted to your insurance plan are greater than what the insurance plan considers normal for the covered service, then your insurance plan may not allow the full amount charged to you. This inflated fee for healthcare services inflates the your coinsurance amounts due at time of service and ultimately impact the future of your health plan.

In scenarios where patients are paying for services “out of pocket” the fees for services deemed unreasonable can be devastating.

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