The allowance for the service(s) rendered or the provider's billed charge whichever is less based on the provider's geographic area.
Ohio Med. A standard monetary amount for any specific service or procedure. Ohio Med will only pay up to the allowed amount or the “Usual, Customary and Reasonable” (UCR) charges. Non-network providers are not obligated to accept the UCR amount as full payment. As a result, you can be balance-billed for any amount that exceeds the allowable amount or UCR. Network providers accept the allowed amount as full payment.
The maximum amount determined by a third party payor to be eligible for consideration of payment for a particular service, supply, or procedure.