Definitions for "Actual Charge"
The dollar amount a doctor or medical supplier charges for medical services or supplies. Compare with Approved Amount.
The amount a doctor or other healthcare provider actually bills a patient. You often see the phrase, "The actual charge may be different from the allowable charge." This means your health plan may only cover a portion of what your doctor charges you. For example, your doctor bills you $35.00 for an office visit. This is the actual charge. But your health plan may only accept $32.00 for an office visit. This is the allowable charge.
The amount of money a doctor or supplier charges for a specific medical service or supply. Because Medicare and insurance companies usually negotiate lower rates for members, this amount is often greater than the “approved amount” that you and Medicare actually pay.