A physician who is a participating provider with Medicare has agreed to:
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A participating provider signs an agreement to accept assignment on all Medicare claims. Accepting assignment means the provider takes the Medicare-approved amount as payment in full: Medicare pays its share, typically 80% of the approved amount after the deductible, and the patient is responsible only for the remaining share, such as a 20% coinsurance. The provider cannot bill the patient for the difference between the approved amount and the provider's usual charge. Nonparticipating providers may charge up to a statutory limit above the approved amount, which the patient must pay out of pocket, making participating status financially favorable for patients.
Why the other options are wrong
- B) Billing the patient the full fee and submitting to Medicare later describes non-assignment billing and allows the provider to charge above the approved amount.
- C) Participating providers do not waive the deductible; the patient must still satisfy the annual Part B deductible before coinsurance applies.
- D) Participating provider status concerns the billing relationship with Original Medicare and is not limited to any particular patient population.
Memory hook
Participating provider = assignment accepted: Medicare's approved price settles the whole bill.