Assignment is the state where medical care is rendered by health professionals for which they receive payment, a fee or reimbursement from the person or entity paying for the service. An assignment can also be a pay order. Assignment of medical expenses and bills is performed for all Medicare beneficiaries, regardless of whether or not they are eligible to receive medical care through Medicare Part A.
The benefit is to reimburse a provider for a service rendered if an insurance carrier or Medicare administration makes a payment for the assignment, as per the rules of the Department of Health and Human Services. Generally the payment is made monthly and the amount paid can vary. It can also vary with payment structures and other factors.
If you become the beneficiary of an assignment, it will usually mean that the hospital, physician or other medical billing agency you choose must also become your assignee. In the case of multiple beneficiaries, a single organization may be assigned to each beneficiary’s account. In most cases, a hospital will be assigned to one beneficiary’s account, while another provider will be assigned to another beneficiary’s account.
Each assignment agreement states who pays what portion of the services provided by the medical billing agency. Once the beneficiary has received payment, the Medicare beneficiary or Medicare intermediary then must obtain payment from the Medicare administrator.
At the point of receiving medical assignment help, the medical professional provides a list of services to the beneficiary along with a detailed description of the services. This is where the medical biller and the beneficiary and/or administrator can negotiate payment amounts.
Typically there are three levels of bargaining power between the beneficiary and the medical billing agent. One is the administrative level, the second is the actual payment and the third is the beneficiary’s ability to negotiate a more favorable payment. Each level has its own rules, restrictions and responsibilities.
The administrative level is the most powerful. Here, the administrator must ensure that the assignment agreement is notarized, signed by both parties and then delivered to the Medicare administrator within 30 days of the date the original assignment was signed. If the agreement is not on file, it will be filed, and the administrator will be notified.
Once the administrative process is complete, the medical billing agent will prepare the claim. Medicare will also provide all the documentation, the medical billing agent needs to prepare the claim.
If there is an agreement to begin the assignment process, the beneficiary and the medical billing agent may meet for an initial meeting. The medical billing agent will ask the beneficiary some questions about how his or her health condition affects his or her ability to pay the full medical bill. At this meeting, the medical billing agent will verify the information provided by the beneficiary.
After the initial meeting, the beneficiary and the medical billing agent should meet for an on-site appointment at the medical billing office. The medical billing agent will complete the medical assignment claim form and return it to the beneficiary to sign.
The claim form is provided to the beneficiary and Medicare administrator along with a Medicare authorization number. The medical billing agent must then submit the Medicare claim for review. If approved, the beneficiary is given a Medicare authorization number.