Approved charge

Also found in: Medical.

Approved Charge

In some health insurance plans, the amount that the insurer will pay for a medical procedure. Some insurers will only pay for medical procedures up to the approved charge. If the amount the physician or hospital bills exceeds the approved charge, the policyholder is responsible for paying it. See also: Coinsurance.

Approved charge.

With traditional fee-for-service health insurance, the insurance company sets an approved or allowable amount for each medical procedure or office visit.

If your bill exceeds the approved charge, the difference between the approved charge and the claim that's submitted to the insurance company for reimbursement is considered an excess charge. You are responsible for that amount in addition to a percentage of the approved charge.

Medicare establishes approved charges for medical procedures and office visits. If you participate in Original Medicare, there's a legal limit on what a doctor, laboratory, or other medical provider can charge in excess of the approved amount.

References in periodicals archive ?
Smith would have had to pay only $220 (20% of the approved charge of $1,100 that Medicare does not pay).
Under the first method, the patient will receive 80% of what the contractor determines is an approved charge for the services after the $155 (in 2010) deductible--regardless of the actual charge.
2 percent of total) were excluded from the estimates because a CPR price equal to the approved charge was not available.
Instead of paying 20 percent of the Medicare approved charge, Mutual of Omaha pays 30 percent, thus, in effect, providing funds that can be used to pay for some, if not all, excess charges.
They also approved charges for care alarms which will mean a PS1m boost to council coffers.
The Maritime Port Authority (MPA) of El Salvador has approved charges for this service, while Costa Rica adapts some rules to facilitate the transaction.
It added that approved charges remained the same within 2013.
4 billion in approved charges for services provided to 10,385,355 Part B fee-for-service beneficiaries.
Notably in the newly approved charges the cost of wholesale international leased line has been reduced by more than 20pc for circuits to some regions and for leased lines, used to provide data services to businesses, the charges have been reduced by up to 40pc.
By Wasil Ali March 4, 2009 (WASHINGTON) -- The International Criminal Court (ICC) announced that its judges approved charges made by its prosecutor against Sudanese president Omer Hassan Al-Bashir.