Question

To indicate that the patient has refused to assign benefits, what code is reported in FL 53 (Assignment of Benefits Certification Indicator):

a. 1
b. 2
c. 3
d. 4

Answer 1

The code to indicate that a patient has refused to assign benefits in FL 53 is b. 2. This refusal means that the patient will be required to pay the healthcare provider directly and then claim reimbursement from their insurance company themselves.

Step-by-step explanation:

To indicate that the patient has refused to assign benefits, the code reported in FL 53 (Assignment of Benefits Certification Indicator) would be b. 2. The Assignment of Benefits (AOB) is an agreement that, once signed, allows the insurance company to pay the healthcare provider directly for the services provided to the patient.

If the patient chooses not to sign the AOB, this means that they will be responsible for paying the bill themselves and then seeking reimbursement from their insurer. FL 53 is a field in the UB-04 claim form used by hospitals and other healthcare facility providers when submitting a claim. The numbers within this field represent different statuses regarding the assignment of benefits:

• 1 would indicate that benefits are assigned
• 2 would indicate that benefits are not assigned (patient refused)
• 3 would represent not applicable
• 4 could mean other specific circumstances, not necessarily related to patient refusal