A  Usual, Customary, and Reasonable ( UCR ) Fee  is the maximum amount of money that an insurance company will pay for a dental procedure. If a dentist charges two million dollars for a filling, the insurance company will only pay the UCR amount.

          Most patients believe that a UCR is what is usually charged by dentists, what is customary for most dentists to charge and what is a reasonable charge for what was done.     No !

          The UCR is what the insurance company decides to pay.

          UCR is the name the insurance gives their payment.

          Different insurance companies have different UCRs.

          Using the name UCR is nice for an insurance company because the insurance company makes the patient think that the dentist is overcharging. The patient never thinks to ask if their insurance company is underpaying.

          When a patient gets into a financial fight with their dentist because the insurance company mislead the patient, the patient sometimes stops going to the dentist. However, the insurance company still collects their monthly premiums and doesn't have to pay out anything. Misleading a patient can mean bigger profits for an unfair insurance company.

          The insurance company can base its UCR on what a rural dentist is charging in an underdeveloped area and not what is normally charged in a big city. The city dentist has to pay more for rent, more for employees, and more for most costs. Patients who live in the city can end up paying more out of their own pockets because of their insurance company's questionable practices.

          The patient who fights these unfair practices can win but very few patients are willing to put the time in to argue with their insurance company.