CPB Certified Professional Biller Certification Practice Exam

What is the definition of "accept assignment" in relation to medical billing?

1. Provider agrees to bill the patient for the entire charge

2. Provider accepts payment in full from the payer

3. Payer agrees to cover all medical costs

4. Patients must pay the full amount upfront

The correct answer is: Provider accepts payment in full from the payer

"Accept assignment" in the context of medical billing refers to the provider's agreement to accept the payment amount determined by the insurance company as payment in full for the services rendered. When a provider accepts assignment, they agree to bill the patient only for any remaining patient responsibility (like copayments or deductibles) and not for the total charges. This practice is beneficial for patients as it minimizes their out-of-pocket expenses and ensures that they are not billed for the difference between what the provider charges and what the insurance reimburses. The other options do not accurately reflect what "accept assignment" means. The notion that a provider agrees to bill the patient for the entire charge does not align with this concept, as it would imply that the patient could be responsible for more than what the insurance covers. Similarly, the idea that the payer agrees to cover all medical costs is misleading, as acceptance of assignment relates specifically to the provider's agreement regarding payment processes rather than the payer's coverage commitments. Additionally, the requirement for patients to pay the full amount upfront is contrary to the concept of accepting assignment, which is designed to alleviate the financial burden on patients.