Every insurance policy???be it travel medical insurance, sports insurance, car insurance, or visitor health insurance???has a clause on UC&R fees, which stands for usual, customary, and reasonable fees. The policy usually covers charges that fall under established UCR limits. What are these fees?
These fees are set by insurance companies. In the context of travel medical insurance, for example, usual fee refers to the fees charged by a doctor for the specific treatment. The customary fee, as the name implies, is the fee determined by the international health insurance plan administrator, and fixes the maximum allowable benefit for that treatment. If a particular treatment runs into complications, the ???reasonable fee??? determines the charges that a doctor can charge.
Establishment of UCR fees helps ensure that hospital and healthcare professionals do not overcharge insurance companies. It varies by geographic area. For international travel health insurance, the schedule is prepared and updated periodically.
However, one of the main problems in claiming reimbursements has been in the area of UCR fees. It usually appears in your statement as ???disallowed fees.??? One thing to do is to double check that the amount has been applied to the appropriate geographic area. Treatment costs vary greatly by country, and even a simple clerical error can prove to be very costly!
