Reimbursement

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Wednesday, June 30, 2004

Getting the right John Hancocks
With Maureen Hanna
M. Hanna

Q. What are the Medicare signature requirements for assignment of benefits?

A. The Medicare Carriers Manual, section 3047.3, defines the requirements for a one-time authorization. For rental of DME the one-time authorization is limited to assigned claims only. Once the provider has obtained the authorization he may submit any later assigned Medicare claims for that equipment without obtaining an additional signature.

When a beneficiary is unable to execute the agreement the request may be executed on his/her behalf by a legal guardian, relative, friend or a government agency providing assistance. The name of the beneficiary should be shown on the signature line followed by “by” and the signature and address of the requestor. Additionally, their relation to the insured and reason beneficiary cannot sign must be entered. Each time an additional item is delivered a new authorization must be signed.

Providers using the extended authorization procedure must file a statement with the carrier that they assume unconditional responsibility for refunding overpayments. Commonly, the following statement is placed on the signature space on the HCFA-1500 claim (or electronic equivalent) “Responsibility for overpayment accepted per statement.”

Contact Maureen Hanna at Healthcare Reimbursement Consultants: 480-837-3229.

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