Thursday, September 30, 2004

Doing away with AOBs
with Clay Stribling

Q.What impact will the proposed changes to the assignment of benefit guidelines have on my documentation policies?

A.Current CMS regulations require a beneficiary to assign a claim to a supplier - using an assignment of benefits form - even if the supplier is required to accept assignment on the item.

Recent regulations proposed by CMS would eliminate the need for certain providers to obtain an assignment of benefits form from the beneficiary. The revised regulations state that “in situations when payment under the Act can only be made on an assignment-related basis or when payment is for services furnished by a participating physician or supplier, the beneficiary (...) is not required to assign the claim to the supplier in order for an assignment to be effective.”

This change would eliminate the need for participating suppliers to obtain AOBs on any items, and would keep non-participating providers from having to obtain AOBs on items for which they must accept assignment. Only if equipment were provided on an unassigned basis would suppliers have to have an AOB. In the preamble to the proposed regulations, CMS noted that this change would help by reducing the paperwork burden on beneficiaries and suppliers.

Clay Stribling, Esq., is an attorney with Brown & Fortunato, P.C. Contact him at (806) 345-6346 or