Question

A billing and coding specialist is filing a CMS-1500 claim form for a patient who has private insurance. The specialist should recognize that a signature approving assignment of benefits indicates which of the following?

The payer should send reimbursement for the claim to the patient, with the exception of copays and deductibles.
The provider will accept the payer's reimbursement as payment in full with the exception of copays and deductibles.
The payer should send reimbursement directly to the provider with the exception of copays and deductibles.
The provider should bill the patient for any difference between the amount billed and the amount reimbursed by the payer.

Answer 1

The payer should send reimbursement directly to the provider with the exception of copays and deductibles.

Explanation: Signing the assignment of benefits on the CMS‑1500 authorizes the insurer to pay benefits directly to the provider (the provider may still collect any patient copay/deductible).