Usual and Customary Explanation

Out of Network Medical Emergency Care 100% of U/C after $50 co-payment

 

The Plan has established a Usual and Customary fee based on the negotiated rate that would have been paid to a participating provider had you used one. This rate is 70% of the amount charged by the non-participating provider.

 

For example, you incur a bill from an out of network hospital for $1,000. We will pay 70% of the charged amount, or $700 as the payable amount, less the $50 co-payment. CampusCare will pay $650.00 of the bill. This would mean the patient could be responsible for $350.00 of the bill.