If your dental office bills directly to your insurance carrier and does not require you to pay up front for the services your insurance covers, your dentist is providing you with a service called assignment of benefits.
In offices that do not provide this service, patients, regardless of their insurance status, are required to pay for their dental treatment at the time of the appointment. Patients are then left to pursue their insurance companies for reimbursement personally.
It is estimated that no more than 30% of dental offices today provide assignment services.
The following is an abbreviated list of the reasons why most dentists do not provide assignment services.
- The provider ends up waiting usually weeks or months for payments to arrive from the insuring agency.
- In order to cope with the large amount of paperwork required to submit and follow up on insurance claims, offices providing assignment must staff considerably more employees than those offices that don’t provide assignment services.
- Once a payment is made to the provider, if any treatment was denied due to exclusions or limitations in the patients insurance plan, there will be a balance owing. In this circumstance the provider now has the responsibility of tracking down the patient for the rest of the payment; sometimes meeting with distrust and hostility on the part of the patient.
So in short, dental offices who provide this service are doing so as a courtesy to their patients to make dental services more accessible. They are making it possible for you to have your dental work done and not be out of pocket for the expenses. They are not required by any provincial or federal legislation to do so and yet they will wait sometimes months for payment on the patient’s behalf.
Keep in mind that it is your responsibility to provide the staff with the proper numbers and insurance information. The limits, restrictions and deductibles on your dental plan were put there by your insuring agency, not the dental office. The dental office has nothing to do with these limitations nor can they do anything about them.
Offices that provide assignment services have the right to revoke them at any time.