Electing to be Non-Participating and Billing Non-Assigned

Home Blog Electing to be Non-Participating and Billing Non-Assigned

In today’s climate of competitive bidding and lower reimbursement, it is challenging for DME suppliers to rely entirely on the assignment model, which meant that Medicare paid the suppliers directly and the patients only had to pay their copayments and deductibles. What we are now witnessing is that an increasing number of DME suppliers are electing to be non-participating and are billing non-assigned.  

If a non-participating supplier provides a product on a non-assigned basis, this means that the supplier (i) is not agreeing to accept the Medicare allowable as payment in full, (ii) can collect directly from the patient, and (iii) can charge more than the Medicare allowable in such cases. The supplier must file the claim with Medicare on behalf of the patient and any Medicare reimbursement will go directly to the patient.  

Click here to read more from Jeffrey S. Baird in a recent article from Medtrade as he discusses what it means when providers elect to be non-participating and bill non-assigned, as well as several key issues pertaining to billing on a non-assigned basis.  


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