Method used by insurance companies and managed care plans to establish their fee schedules in which three fees are considered in calculating payment: (1) The usual fee is the fee typically submitted by the physician, (2) the customary fee falls within the range of usual fees charged by providers of similar training in a geographical area, and (3) the reasonable fee meets the aforementioned criteria or is considered justifiable because of special circumstances.
Insurance Encyclopedia
Usurped power
This is: ‘(a) invasion by foreign enemies to give laws and usurp the government, or (b) internal armed force in rebellion assuming the power of government by making laws and punishing for not obeying those laws. Usurped power involves organised tumult or open warfare, and must be something more than action by a mere unorganised rabble; it implies a more or less organised body with more or less authoritative leaders’. (F.H. Jones).