Meaning of Accept Assignment ?
For purposes of this agreement, assignment of the Medicare payment under Part B means requesting direct payment from the Medicare program. Under an assignment, the allowable charge (to be determined by the DMEMAC/carrier/PMAC) will be the reflected as the total of the charge for the Part B covered services. The participant may not impose on the beneficiary or other person or entity for covered services more than the applicable deductible and coinsurance.
Effective Date – During after enrolment period, if the applicant files the agreement with MAC/carrier, the agreement becomes effective after _______ .
3. Term and Termination of Agreement – This agreement will remain in force until 31 December after the date on which the agreement comes into force and will be automatically renewed every year from 1 January to 31 December of the following year, unless one of the following situations occurs:
a. Within the enrollment period, provided near the end of every calendar year, participant sends written notice to each MAC/carrier with whom participant has filed or submitted a copy of the agreement that the participant desires cancellation of the agreement at the end of the current term. If such a notice is mailed or delivered during the enrollment period, near the end of every calendar year, then the agreement terminates on December 31 of that year.
b. If, after written notice and an opportunity for a hearing for the participant, the Centers for Medicare Medicaid Services finds that the participant has substantially violated the agreement, the Centers for Medicare and Medicaid Services will give the participant written notice that the agreement is to be terminated at the time designated in the notice. The participant may be subject to civil and criminal sanctions for violation of the agreement.