Medicare Assignment example and definition

Medicare assignment refers to an agreement between a healthcare provider and Medicare (CMS) to accept the Medicare-approved amount as full payment for covered services. When a healthcare provider accepts a Medicare assignment, they agree to bill Medicare directly for the services provided and to accept the Medicare-approved amount as full payment, which means that they cannot charge the patient more than the Medicare-approved amount. Here is an example of a Medicare assignment:

Let's say that a Medicare beneficiary needs to see a doctor for a medical condition. The doctor charges $150 for the visit, but the Medicare-approved amount for the visit is $100. If the doctor accepts the Medicare assignment, they will bill Medicare directly for the visit and accept the $100 Medicare-approved amount as full payment. The Medicare beneficiary will be responsible for paying any required coinsurance or deductible amounts, but will not be responsible for paying the difference between the doctor's charge and the Medicare-approved amount.

In this example, if the doctor does not accept a Medicare assignment, they may charge the patient up to 15% more than the Medicare-approved amount for the visit, which is called the limiting charge. If the doctor charges the limiting charge, the Medicare beneficiary may be responsible for paying the difference between the doctor's charge and the Medicare-approved amount, as well as any required coinsurance or deductible amounts.

Medicare assignment is an agreement between a healthcare provider and Medicare to accept the Medicare-approved amount as full payment for covered services. It helps to ensure that Medicare beneficiaries have access to affordable healthcare services and that they are not responsible for paying excessive out-of-pocket costs.

MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further explanation.