AAPC - Back to school
Results 1 to 3 of 3

Thread: Not accepting assignment with Insurances

  1. #1

    Default Not accepting assignment with Insurances

    AAPC: Back to School
    I have a general question about accepting assignment and responsibility of the patient. If we do not participate with an insurance for example, Tricare, and the claim is marked that we DO NOT accept assignment...once we get the EOB back from the insurance, is the amount we charged for the visit-- the full responsibility of the patient .. or do we have to take off any adjustments that the EOB states ?
    Thank you for any guidance!!!!

  2. #2
    Join Date
    Apr 2007


    It is my understanding that if you are not contracted, you are not required to take the contracted write off. Insurance EOB's will still list them, and a patient may call and question why you did not take the adjustment, but if your office was clear on the billing and clear with the patient when the appointment was made, that you are not a contracted provider, then the write off is not manditory. But be very sure before you balance bill a patient, that there is not a contract for your provider with the payer.

    Hope that helps,


  3. #3
    Join Date
    Apr 2007
    Concord, NC or Rochester, NY


    Depends on the insurance.

    Medicare for example you can only charge 15% above the allowed amount if you do not participate. Most commercial insurance carriers you can charge your U&C and it will be the responsibility of the patient to pay the difference as you do not participate. I forget the rules around tricare since it is so small in the geographic areas I deal with.

Similar Threads

  1. HELP!!! Same Dr. Two DX/Two Insurances
    By q1stmdb in forum E/M
    Replies: 2
    Last Post: 06-21-2013, 11:11 AM
  2. 2 different insurances during pregnancy
    By kbice in forum OB/GYN
    Replies: 2
    Last Post: 03-20-2012, 02:07 PM
  3. patient with two insurances
    By lec121661 in forum Employment General Discussion
    Replies: 9
    Last Post: 12-04-2010, 12:26 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.