decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Billing Services / Reasons for revoking assignment privileges
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Article Overview
This article covers Medicare policy on when a provider’s right to receive assigned payment for physician services may be revoked, along with related conditions, exceptions, and indirect ownership considerations. It is intended for billing and compliance audiences who need a general understanding of the circumstances that can affect assignment privileges and provider payment arrangements.
Why This Topic Matters
Assignment privilege revocation can affect how physician services are billed and whether assigned payment is allowed. Understanding the policy context helps billing, compliance, and provider-office staff recognize when Medicare payment arrangements may be impacted.
What You Will Learn
- The general circumstances under which assignment privileges may be revoked
- How billing services arrangements can affect assigned payment
- What happens after a provider’s right to accept assignment is revoked
- How exceptions involving related entities and ownership interests are described in the policy
- The role of Medicare carriers, intermediaries, and CMS in enforcing assignment rules
Who Should Read This
- Medical billers
- Coding and compliance staff
- Physician practice administrators
- Revenue cycle professionals
- Healthcare attorneys and auditors
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