I submitted an assigned claim. Why was the payment sent to the patient?

Patients can receive payment on covered services when a claim is submitted with an amount in item 29 of the CMS-1500 (02/12) claim form. Item 29 should only be completed to report the amount a patient has paid for covered services. Submitting an amount in item 29 may result in payment being made to the patient.

Providers should not use item 29 to report the amount a primary insurance paid on the service or the amount Medicare paid on a previous submission of the claim.

Resource: CMS IOM Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, Section 10.4 (PDF, 640 KB)

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