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Could you tell me what "accept assignment" means in block 27 on the HCFA 1500

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Alice Scott:
Question
Could you tell me what "accept assignment" means in block 27 on the HCFA 1500 form?
Teri C

Answer
Hi Teri,
Block 27 "accepts assignment" on the HCFA 1500 form is to indicate whether the provider of service or supplier  accepts assignment of benefits.  In other words, it means that the provider accepts what the insurance carrier allows as payment in full.  If a provider participates with an insurance carrier they have a contract and agree that the provider will accept the allowed amount so the provider would check "yes".  If they do not participate and do not wish to accept what the insurance carrier allows, they would check "no".  A provider who does not participate can opt to accept assignment on just a particular claim by checking the "yes" box just for those services.
Michele

Another Question
Thanks, but I'm still unclear about something.  When you check "no" doesn't the insurance payment go to the patient?
Teri

Answer
Checking "no" does not necessarily mean that the payment will go directly to the patient.  It actually depends on each individual insurance carrier.  I can't give you a straight yes or no answer.  In my opinion, checking "no" means there is a good chance that the payment will go to the patient.  To be sure, you would need to call the insurance carrier to see how they process claims with "no" in the assignment box.  Some companies mail the payment to the provider no matter what, and others send the payments to the patients if the provider is not in network.
I hope this helps a little.
Michele

rdmoore2003:
if you are a non-participating provider and check 'yes' in the accept assignment box, what does this mean?  Where can you find state laws on this to back up

Michele:
If you are non par but you check the yes on the assignment box, it means that you are choosing to accept assignment on the charges that are on that claim.  In other words you are willing to accept the insurance carriers allowed amounts for the charges being billed.  I am not aware of any web site with the laws regarding this.

Michele

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