All our physicians participate in Medicare and accept assignment. “Accepting assignment” means that we accept the approved Medicare charge and will only bill the patient for the yearly deductible and the 20% Medicare does not pay. Many patients have secondary insurance coverage for the 20%. If you supply us with the secondary payer information, our office will send the secondary payer a claim. However, the patient is ultimately responsible for the 20% and/or the deductible. Some secondary insurance coverage through managed care companies requires a referral at the time of the visit for payment of the 20%. Be sure and check with your secondary payer as to their rules prior to your visit to our office.