Dental Insurance Assignment of Benefits Defined
Dental insurance assignment of benefits is line 37 on a claim form. To clarify, this authorization requires a subscriber signature. However, most dental practice software prints “signature on file” in this field. And this is a set-up within the practice software. But dental plans may also work around this. And write their own rules, as dental insurance companies often do.
Many Dental PPO insurance plans only pay the provider. And this is especially true for contracted providers. Even if this line item is unauthorized, payment goes to the provider. But some insurance companies only pay the subscriber. This happens mostly with obscure dental plans we seldom encounter. And even when we authorize payment to the dentist, the check goes to the subscriber.
What Do We Do?
Most of the time, we want the checks to come to us. Hands down! But what about those times a patient has a funky insurance? We think, this might be a workable solution! The practice requests payment in full. And then do not authorize payment to the practice. Instead, send the check to the patient. Leave line 37 blank on the form. No refund check to write. No worries. Right?
Maybe! Or perhaps the insurance company issues the check to the practice anyway. Perhaps that’s just their policy. Maybe someone just makes a mistake. And the patient calls the office upset that the check is not in their mailbox. The insurance company tells them it’s been mailed to the dental office. Now what? Because the check isn’t at the office yet. The delay continues. Then the patient continues to call the office. And what if the check is lost in the mail? And now we must resend the claim.
Dental Insurance Assignment of Benefits Always
Dental insurance assignment of benefits is a must for me. No matter what the situation, I check this authorization. Mostly because I want control over the claim and payment. At least as much as possible here! And if there is a chance I can receive the payment, I want to. Even if it means the practice writes a refund check to the patient! Because I would much rather write a check than send a statement. Wouldn’t you?
With obscure insurance plans, I ask for payment in full from my patient. And I still ask for the insurance check. This does a couple of things for me. It shows me how quickly they pay and gives me a little insight into the plan with the explanation of benefits. And may build a relationship that I trust a little more. Sure, I now have to send a refund check. But, that’s okay with me.
What If The Patient Complains?
There may be a patient that wants to receive the insurance check. And I can understand their request. After all, I have just requested payment in full. So, I’ll allow room for their request. But, I also explain my why. I share with the patient I want to see how quickly their insurance processes their claim and pays. And I want to see how their benefits work and what they are. Because the office may be able to change the billing procedure for them.
Then, I leave the final decision with the patient. This also gives the patient a bit more involvement in the process. We can certainly continue with payment in full if the patient prefers. And allow the assignment of benefits to remain unauthorized. But, we also want to inform our patient the insurance company may pay us anyway. Because some insurance companies write their own rules regardless of this authorization and our request.
