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Understanding Assignment (Health Care): A Legal Perspective
Definition & Meaning
In the context of health care and Medicare, "assignment" refers to an agreement between a doctor or supplier and Medicare. When a provider accepts assignment, they agree to accept the Medicare-approved amount as full payment for their services. This means that the provider will bill Medicare directly for the services rendered, rather than charging the patient. Accepting assignment can help patients save money, as the provider is limited to the Medicare reimbursement rate.
Table of content
Legal Use & context
The term "assignment" is primarily used in health care law, particularly in relation to Medicare. It is relevant for providers who participate in Medicare and for beneficiaries who seek services covered by the program. Understanding assignment is crucial for both patients and providers, as it affects billing practices and out-of-pocket costs. Users can manage related forms and processes through resources like US Legal Forms, which offers templates designed by legal professionals.
Key legal elements
Real-world examples
Here are a couple of examples of abatement:
Example 1: A doctor charges $150 for a consultation. If Medicare approves $120 for that service and the doctor accepts assignment, they will bill Medicare $120 and the patient will not owe more than that amount.
Example 2: A physical therapist charges $200 for treatment. Medicare's approved amount is $160. If the therapist accepts assignment, they will receive $160 from Medicare, and the patient will not be charged the difference. (hypothetical example)
Comparison with related terms
Term
Definition
Difference
Assignment
An agreement for a provider to accept Medicare payment as full.
Focuses on provider agreements with Medicare.
Non-assignment
A situation where a provider does not accept Medicare's payment as full.
Patients may owe more if the provider does not accept assignment.
Common misunderstandings
What to do if this term applies to you
If you are a Medicare beneficiary, check whether your provider accepts assignment. If they do, you can expect lower out-of-pocket costs. If you are a provider, consider accepting assignment to attract more Medicare patients. For assistance, explore US Legal Forms for templates that can help you manage the necessary paperwork.
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Possible penalties: Providers may face penalties for not following Medicare billing rules.
Key takeaways
Frequently asked questions
If your provider accepts assignment, they agree to bill Medicare directly and accept the Medicare-approved amount as full payment.
Yes, providers can choose whether or not to accept assignment for Medicare services.
When a provider accepts assignment, your out-of-pocket costs are typically lower because they cannot charge you more than the Medicare-approved amount.