G ove r n men t Re lat ions
from their dentist of choice, even though
they are paying for a benefit that should
be applied to any provider, regardless of
whether or not the provider participates
with the patient’s insurance plan.
• Absence of assignment of benefits
legislation forces patients to pay up-front
for treatment they may not be able to
afford. This is particularly difficult for
divorced or separated parents, single
mothers and low-income families. It would
be much easier for a patient to have the
ability to assign the dental benefit directly
to the provider.
• Parents who are divorced or separated
may experience the problem where one
parent has custody of a child while the
other parent carries the insurance. The
latter may never send the insurance check
to the custodial parent, who had to pay
for services upfront. Faced with this
situation, many custodial parents postpone
or avoid care altogether. This could also
impact the dentists, who sympathize with
the parent and see the child without
requiring advanced payment. Often these
dentists are never paid.
• Patients residing in rural areas are placed
at a disadvantage as there may only be a
handful of dentists who are in-network.
Patients may have to incur more traveling
time and expense to seek treatment
from an in-network provider, rather than
being treated by a non-participating
dentist who practices in closer proximity.
• Insurance companies oppose assignment
of benefits laws because they want more
dentists to join their networks. Studies
have proven that network participation
did not decline in states with assignment
of benefits laws. After passing assignment
of benefits legislation, Florida conducted
a study and found provider networks
remained the same. When asked,
representatives from insurance companies
were not able to provide data from any of
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SE P T E M B E R/OC TOBER 2017 | P EN N S YLVA N IA D EN TA L J O UR N AL