Reasonable and Customary Fees 2017, Paramedical Services
We review reasonable and customary limits on a continual basis and make changes periodically to ensure that our allowed amounts are representative of the current standard fees in the health care environment. Our most recent review has allowed us to raise the limits of some initial paramedical care treatments. The new reasonable and customary limits will take effect on January 1, 2017.
What are reasonable and customary fees?
Reasonable and customary fees refer to a range of fees most practitioners normally charge for paramedical services or treatments. A fee is considered reasonable and customary if it matches the average cost of that service within a geographic area.
How do these limits affect the payment of claims?
Limits will be applied to claims for paramedical services if the provider charges more than the reasonable and customary limit. Plan members will be responsible for paying the difference. Limits are also subject to any deductibles and plan reimbursement percentages according to plan specifications.
Where to find the updated list?
You may refer to the list of reasonable and customary fees in My Client Space, in the Document Centre under “Guides and Resources”. The list will be available on December 1, 2016.
For further information regarding your coverage on reasonable and customary fees for paramedical services, please refer to your booklet or contact our customer service department at 1 877 422-6487.
If you have any questions, please contact your advisor or your iA Financial Group Account Executive.