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Title
Physicians' charges under Medicare: assignment rates and beneficiary liability.
First Author
Ferry, Thomas P
Date of Pub
1980 Winter
Pages
49-73
Volume
1
Issue
3
Other Authors
Gornick, Marian; Hackerman, Carl; Newton, Marilyn
Abstract
Under Medicare's Part B program, the physician decides whether to accept assignment of claims. When assignment is accepted, the physician agrees to accept as full payment Medicare's allowed charge. Physicians' acceptance of assignment is of considerable importance in relieving the beneficiaries of the burden of the costs of medical care services. This factor and the beneficiaries' liabilities for premiums, the annual deductible, and coinsurance are analyzed in considerable detail in this report. Data from physicians' claims for services in 1975 show that 45.8 percent of the services and 47.2 percent of the charges were assigned for the aged. There were wide variations in the rate of acceptance of assignment by physician specialty, and by age, race, and residence of beneficiaries. Total beneficiary liability from the deductible, coinsurance, and from unassigned claims amounted to 37.7 percent of total physicians' charges due. When the premium which the beneficiary pays for Part B is included, beneficiary liability rises to 69.2 percent of total physicians' charges due.
Abstract Continued
N/A
MeSH
Fees, Medical : Insurance, Health : Insurance, Health, Reimbursement : Aged : Human : Medicare/economics : Patient Credit and Collection : United States
NTIS Number
PB81-112831