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Usual, Customary or Reasonable (UCR)

An industry term for the typical rates charged for services in a specific region. For example, if a surgeon in Virginia were to charge twice as much for a surgery as the average cost of that procedure in the area, those charges would not be considered usual, customary or reasonable.

Excessive Waiting Period

The Affordable Care Act prohibits excessive waiting periods for employer-sponsored insurance coverage, defined as waiting periods over 90 days. In other words, an employer cannot…