Which of the following is considered a non-participating provider?

A provider that does not accept Medicare assignment is classified as a non-participating provider. This designation means that the provider has chosen not to accept the Medicare-approved amount as full payment for services rendered. Consequently, this type of provider can bill the patient the difference between their own billed charges and the Medicare reimbursement, which can sometimes lead to higher out-of-pocket costs for the patient.

In contrast, a provider that accepts Medicare assignment agrees to accept the Medicare-approved amount as payment in full. This arrangement typically results in lower costs for patients, as participating providers cannot charge more than the agreed-upon rates. Providers with contracts with insurance companies are considered participating providers for those plans, and those who accept cash payments may not fall into a specific category regarding Medicare participation. Thus, the distinction is crucial for understanding billing practices and patient costs associated with different types of providers.