Reassignment of Benefits

A Medicare enrollment action where an individual provider authorizes their Medicare payments to be made to a group practice or employer instead of directly to the individual provider.

Reassignment of benefits is how you tell Medicare to pay your group practice instead of paying you directly. If you are an employed physician or a provider working in a group practice, your Medicare payments need to go to the group's bank account, not yours. Reassignment makes that happen. The reassignment is set up during the enrollment process. On your CMS-855I (individual enrollment), you indicate that you are reassigning your benefits to a group. You provide the group's legal business name, tax ID, and NPI. The group must also have an active CMS-855B enrollment. Medicare links your individual enrollment to the group's enrollment through the reassignment. Without a properly set up reassignment, one of two things happens. Either Medicare pays you directly as an individual, which creates accounting chaos if you are supposed to be billing through a group. Or, more commonly, claims submitted under the group's billing NPI with you as the rendering provider get denied because Medicare does not see a valid link between your individual enrollment and the group's enrollment. Reassignment issues are one of the top reasons Medicare claims deny for new providers joining existing group practices. The group files a claim, lists the new provider as the rendering provider, and the claim denies because the reassignment has not been processed yet. PECOS reassignment processing can take 30 to 60 days. You can reassign your benefits to more than one group if you work at multiple practices. Each reassignment requires a separate update in PECOS. And when you leave a group, you need to terminate the reassignment so the old group can no longer bill under your NPI. Check your reassignments in PECOS periodically. Make sure they are current, that old groups have been removed, and that all active groups are listed. Stale reassignments to groups you left years ago are a compliance risk.