You may be billed for unmet portions of the annual deductible and the coinsurance. You may contact us at the address or the telephone number in the Customer Service Information Box on the front of this notice for a list of participating providers who always accept assignment. You may save money by choosing a participating provider. Doctors who submit unassigned claims have not agreed to accept Medicare's approved amount as payment in full. This is known as a Limiting Charge.
Some states have additional payment limits.
Be Billed column is your share of the cost for the services on this notice. You may not have to pay for certain denied services. If you have supplemental insurance, it may help to pay these amounts. If you use this notice to claim supplemental benefits from another insurance company, make a copy for your records. All Medicare payments are made on the condition that you will pay Medicare back if benefits could be paid by insurance that is primary to Medicare.