A physician who 'accepts assignment' under Medicare agrees to:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A participating physician who accepts assignment agrees to take the Medicare-approved amount as payment in full for covered services. Medicare pays its share, generally 80% after the annual Part B deductible, directly to the provider, and the beneficiary is responsible for the remaining 20% coinsurance. Because the provider accepts assignment, there is no balance billing above the approved amount. A non-participating physician may decline to accept assignment on a given claim and may collect an excess charge up to a statutory limit, which is why assignment status directly affects the beneficiary's out-of-pocket cost for a visit.
Why the other options are wrong
- B) The model of billing the beneficiary in full for the beneficiary to seek reimbursement describes how non-assignment arrangements can work. A provider who has accepted assignment submits the claim and receives payment from Medicare directly.
- C) Accepting assignment means accepting the approved amount as full payment. Charging more would be balance billing above the approved amount, which the assignment agreement prohibits.
- D) Medicare generally pays 80% of the approved amount for covered Part B services, not 100%. The beneficiary remains responsible for the 20% coinsurance after the deductible.
Memory hook
Assignment = 'the approved price is the full price.' No surprise balance bills.