How is Box 27, “Accept Assignment,” on the HCFA-1500 form used when sending electronic claims?
When sending claims electronically, there are differences between how this box is used for commercial claims versus government claims (such as Medicare). The following is a clarification of these differences: Government Claims (Medicare, CHAMPUS, etc.) Use of HCFA-1500, Box 27 For government claims, Box 27 has two meanings. 1. It indicates who is to receive payment. “Yes” indicates payment should go to the provider shown in Box 33. “No” indicates payment should go to the patient. 2. If “Yes” is checked, the provider indicated in Box 33 has agreed to accept as “payment-in-full” whatever Medicare is going to pay. No further charges are to be billed to the patient. Commercial Claims Use of HCFA-1500, Box 27 For commercial claims, if the physician or clinic does not have a contract with the commercial carrier, Box 27 has only one meaning it indicates to whom payment is to be made. Whether a “Yes” or “No” is checked, the physician can still bill the patient for unpaid balances due for servi
