What is the Purpose of Accept Assignment for Claims?

This article gives some explanation of the use of 'Accept Assignment' on claims. Click the link for directions on how to indicate accept assignment within MacPractice.

The 'Accept Assignment' element of the Claim refers to the relationship between the provider and the payer. This field is not for reporting whether the patient has assigned benefits to the provider or office. That element is determined by the subscriber's (Primary/Secondary) 'Signature on File'. The linked article explains how subscriber's 'Signature on File' affects the insurance company payment to the office.

Be sure to only pay attention to Primary/Secondary signature on file in regards to this matter. Provider Signature on File should NEVER be unchecked for any reason in the template override values.

The specific 'Accept Assignment' relationship does not have a standardized definition and can mean something completely different from one payer to another.

The National Uniform Claim Committee (NUCC) says simply that the 'Accept Assignment' element indicates that the provider agrees to accept assignment, without any clear definition as to what accepting assignment means.

Participating with Medicare
For Medicare claims the subscriber's 'Signature on File' is not enough to ensure that payment will come directly to the provider instead of the patient. To ensure that payment goes to the provider, 'Accept Assignment' must be indicated on the claim.

Participating with Non-Medicare Payers
If a provider participates with a payer, the terms of the contract must be followed. Contract terms supersede any general guidelines regarding accepting of assignment.

If a provider does not participate with a payer, they may choose to not accept assignment.

Generally, accepting assignment, in conjunction with having the subscriber's signature on file, ensures that payment will go to the office. Even if the provider has been assigned benefits by the patient, payment is only guaranteed to go to the provider if the provider also accepts the payers assignments.

If patients pay for their services and are reimbursed by their insurance company, it is appropriate to not accept assignment from the payer.
Note: If YES is selected for 'Accept Assignment' the office may or may not be subject to a lower fee schedule, however if it is NOT selected, the payment might not go to the office at all.

CDA (Canadian Dental Association) Claims
'Accept Assignment' is very important where it concerns CDA (Canadian Dental Association) claims, if the office wishes to receive payment from carriers, rather than the payment go to the patient, that 'Accept Assignment' is indicated on the claim. This has greater impact on Canadian claims than does subscriber 'Signature on File'.

If a Canadian office is claiming that patients are receiving the payment when the office should be, 'Accept Assignment' is the first and most important item to double check.

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