Question

Assignment is a written agreement between beneficiaries, their physicians or other suppliers, and Medicare. The beneficiary agrees to let the physician or other suppliers request direct payment from Medicare for covered Part B services, equipment, and supplies by assigning the claim to the physician or supplier. As a result of a physician accepting assignment, the he/she must follow certain requirements. Which of the statements does NOT accurately reflect the requirements of physicians accepting assignment?

1) The physician must accept the Medicare-approved amount as full payment for the covered services.
2) The physician must submit claims to Medicare on behalf of the beneficiary.
3) The physician must agree to charge the beneficiary more than the Medicare-approved amount.
4) The physician must agree to accept assignment for all Medicare-covered services.

Answer 1

The incorrect statement among the options provided is that the physician must agree to charge the beneficiary more than the Medicare-approved amount, as this directly contradicts the principle of accepting assignment, which is to accept the Medicare-approved amount as full payment.

Step-by-step explanation:

The student's question concerns the requirements for physicians and other suppliers who accept assignment from Medicare under the Part B optional insurance system for covered services outside hospital stays, such as physician services, medical tests, and outpatient visits.

The question asks which statement does not accurately reflect the requirements of physicians accepting assignment, among the provided options.

When a physician accepts assignment, they must adhere to specific requirements:

• The physician must accept the Medicare-approved amount as full payment for the covered services.
• The physician must submit claims to Medicare on behalf of the beneficiary.
• The physician must not charge the beneficiary more than the Medicare-approved amount.
• The physician must agree to accept assignment for all Medicare-covered services.

Therefore, the statement that does not accurately reflect the requirements is:

1. The physician must agree to charge the beneficiary more than the Medicare-approved amount.

This statement is incorrect because accepting assignment means that the physician agrees to the Medicare-approved amount as the full payment, and cannot charge the beneficiary more.