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Assignment of Benefits (AOB) Guidelines

If you are a participating supplier, then you are required by Medicare to accept assignment. If you are a nonparticipating supplier, then you may choose on a claim-by-claim basis whether or not you would to accept assignment. Nonetheless, if you are going to bill a claim assigned, you must have an Assignment of Benefits (AOB) form signed and dated by the patient.

Accepting assignment indicates that you agree to accept the allowable that Medicare assigns to the item as payment in full and will not bill the patient more than his/her deductible or copay (20%) amounts. By signing this agreement, the patient agrees that he/she will allow Medicare to pay you his/her benefits based on the coverage that Medicare determines. You, as the provider, may request a review or appeal if you do not agree with the Medicare approved amount, but you may not bill the patient for the difference between the allowed and the billed amount.

You must be sure to have the AOB in the patient's file. You must also be sure to have each item that the patient received on the form, or a one time payment authorization which will apply to the current claim and any future claims you have for this patient. When you transmit (or mail) the claim, you do not need to include a copy of this form; you only need to indicate that the patient signed the form (Signature on File) and on what date he/she signed it. If the patient is physically or mentally unable to sign the form, a representative may sign it for him/her, but the signature line must also clearly indicate the patient's name, who the representative is, the representative's address and relationship to the patient and why the patient cannot sign.

Be aware that if Medicare audits you and requests a copy of this form and it is not completed to their specifications, they will request an overpayment. You must have this information on file before you bill Medicare.

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