A Medicare provider who 'accepts assignment' agrees to:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A provider who accepts assignment, known as a participating provider, agrees to accept the Medicare-approved amount as payment in full for covered services. The provider files the claim with Medicare and may charge the beneficiary only the applicable deductible and coinsurance — not the difference between the approved amount and the provider's usual charge. A non-participating provider may treat beneficiaries too, but can balance bill within limits. Assignment protects beneficiaries from surprise charges above Medicare's approved fee. Beneficiaries who see non-participating providers are responsible for the balance above the approved amount, which is why agents advise clients to confirm that their providers accept assignment before treatment.
Why the other options are wrong
- B) Charging any amount chosen is the behavior of a provider who does not accept assignment, and even then balance-billing is limited by Medicare rules.
- C) Participating providers file claims with Medicare on the beneficiary's behalf; they do not require the patient to pay in full and seek reimbursement.
- D) Participating providers accept Medicare patients; that is the definition of assignment.
Memory hook
Assignment = the provider takes Medicare's price as final. No surprise upcharge above the approved amount.