On the CMS-1500 claim form, Box 27 tells the payer whether the practice accepts assignment — whether it agrees to the payer's terms and takes payment directly from the payer. This guide explains what the box means and how Pabau fills it.
NOTE: This article is part of the US Insurance Billing Additional Resources series, which walks through every box of the CMS-1500. If you are new to claims in Pabau, start with Creating a US Professional (CMS 1500) Claim.
Box 27 — Accept assignment
Box 27 is a YES / NO pair of checkboxes. Marking YES means the practice agrees to be paid directly by the payer under the payer's terms; marking NO asks the payer to send payment to the patient instead, leaving the practice to collect from the patient. Providers who are contracted (in-network) with a payer are generally required by their contract to accept assignment, and the exact rules vary by program — the form itself notes that government claims have their own conditions — so check your payer agreement if you are unsure which way to answer.
How Pabau fills it
The value comes from the Accept assignment select in the Claim details section of the claim, and it defaults to Yes (Y): the practice accepts the payer's allowed amount and payment comes to the practice. You can change the answer on the claim before validating and sending it.
On the electronic claim: the same Yes/No choice is sent with the claim, and the printed form marks the matching checkbox, because the print renders from the same validated claim data as the electronic file.
NOTE: Box 27 works together with the signature authorizations in Boxes 12 and 13: Box 13's payment-of-benefits authorization is what routes the payer's payment to the practice, and accepting assignment in Box 27 is the practice's side of that arrangement.
TIP: Leave the field on Yes unless your arrangement with the payer says otherwise — it is what sends the payer's payment to the practice rather than to the patient.
To submit and track claims end to end, see Insurance Guide Part 4: Submit and Track Insurance Claims in Pabau.