G ove r n men t Re lat ions
PDA Action Alert: Assignment of Benefits
Moving Through the House
Contact your Representative IMMEDIATELY to Request
Support for SB 373, printer’s number 1287
Good News: SB 373 passed out of the House Insurance
Committee in June.
Bad News: The Committee amended SB 373, essentially
changing the legislation to require dual signature, and
prohibiting dentists from balance billing when they do accept
the assigned benefit directly. It also extends the effective date
from 60 to 240 days. PDA does not support this amendment.
Our message now is clear: Ask your Representative to
support SB 373 with prior printer’s number 1287. This is the
version that p assed the Senate before it was amended. We
want the House to pass the same bill that passed the Senate.
Your participation in this process is essential to moving SB 373
through the House of Representatives and on to Governor Wolf
for his signature. Please contact your Representative and
request his or her support for SB 373, printer number 1287.
It will only take a few minutes of your time to make a big
investment in your practice. Ask your family, friends, office staff
and colleagues to also contact their Representative. We provide
talking points and a sample letter. Contact PDA at
[email protected] or (800) 223-0016 for the sample letter.
PDA is optimistic that the House of Representatives will pass
SB 373 before the end of session this fall. But we need a united
front to counter the insurance lobbyists hard at work opposing
this bill. Legislators will count how many dentists contact
them about SB 373 when deciding how to vote. They will
assume this legislation is not important to dentists if they don’t
hear from you.
Find your representative’s contact information here:
www.legis.state.pa.us.
TALKING POINTS:
• The House Insurance Committee’s amendment further
complicates an already complicated billing process. Requiring
dual signature is a burden to patients who must sign the
check and mail or drop the check off at the dental office.
Assigning the benefit directly is much easier for patients.
• Most dentists are small business owners with significant
overhead costs and employees to pay. Prohibiting them from
balancing billing in certain situations is a financial burden
that could impact the solvency of their practice, hindering
patients’ ability to access care.
• Some patients cannot see their dentist of choice because
some insurance companies do not directly pay the non-
participating provider, and the patient cannot afford to pay
for services upfront. Dentists who do not require advanced
payment may never be paid for services rendered. This
insurance practice unfairly inhibits patients from seeking care
from their dentist of choice, even though they are paying for
a benefit that should be able to be applied to any provider,
regardless of whether or not the provider participates with
the insurance plan. The insurance is a purchased product and
belongs to the patient.
• Absence of assignment of benefits legislation forces patients
to pay upfront for treatment they may not be able to afford.
This can be particularly difficult for divorced or separated
parents, single parents and low-income families. It would be
much easier for patients to have the ability to assign their
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
parent postpone or avoid care altogether. This could also
impact the dentist, who sympathizes with the parent and
sees 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.
• 23 other states have enacted assignment of benefits laws.
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