What is the difference between an assigned and a non-assigned claim?
An assigned claim means the provider will accept the Medicare allowed amount as full payment for a given service. Medicare will make payment directly to the provider. The patient is responsible for the co-insurance, which is the difference between the Medicare allowed amount and the amount Medicare paid directly to the provider. The coinsurance is usually 20% of the allowed amount. For example, if Medicare approves payment to the provider for $100.00, Medicare would pay 80% ($80.00). It is the patient’s responsibility to pay the difference between what Medicare allowed and what Medicare paid. In this case, the patient would pay $20.00 (20% of the Medicare allowed amount), unless the have a secondary or supplemental insurance. A non-assigned claim means the provider will not accept the Medicare allowed amount as full payment. Medicare will make payment to the patient. Most services are subject to “limiting charge’ regulations. The provider cannot charge the patient more than 115% of th
