By billing the claim as an “unassigned” claim (also called non-assigned).
What is an unassigned claim?
An unassigned claim is when a non-participating provider does not accept “assignment” from Medicare for the claim. This is an option for our titanium TiLite chairs because they are not competitively bid.
What is required to bill unassigned?
The provider must still file the claim on behalf of the user, but does so unassigned. The documentation and justification paperwork is still the same as a “normal” claim when submitting.
How does the provider get paid?
Once the unassigned claim is sent to Medicare by the provider, the user pays for the entire cost of the chair upfront. Once the claim is approved, Medicare pays the allowed amount for the chair directly back to the enrollee.
What are the advantages of billing unassigned?
For the user of the chair, they can continue to get the product they want and deserve and still, at the end of the day, only pay for the cost of the upgrade and their co-pay out of pocket like before. For the provider, they get the cost of the chair paid at the beginning without having to wait for Medicare to pay them back.
Bottom line, handled correctly, the result should be:
- Affordable reimbursement for the provider.
- Faster return on the provider’s investment.
- Same financial outcome for the beneficiary.
- Access to the product they wanted and could afford.
Have an interested user or dealer? Tell them to reach out to Jim Stephenson at firstname.lastname@example.org for more details about billing unassigned and how they can ensure their clients get the best, most appropriate product they want and deserve!