Dental Insurance and Direct Billing

  • What is non assignment & assignment?

    Non assignment is where the patient pays upfront for treatment provided the day of their appointment. Office staff would provide the patient with a receipt to submit to their insurance company, or they may send your payment information electronically to your insurance company for the patients insurance company to reimburse the patient directly.

    Dental assignment is where your office can send your invoice electronically or manually for services rendered the day of your appointment ( Direct Billing ) . The insurance company may send back an immediate response on the portion they will cover. The insurance company will then issue a payment to your office for that amount. The office will collect the portion not covered by insurance from the patient, on the day of treatment.

    Does every insurance company do Direct Billing?

    Not all insurance plans allow for direct billing, Office staff can contact your insurance company, and get what is called an Insurance Breakdown. The insurance company will then explain to office your coverage, and whether or not they accept assignment, or electronic data interchange (EDI). Please be advised that some insurance companies will only communicate with the plan holder and we maybe limited to the information we receive.

    My insurance company doesn’t accept assignment or EDI, now what?

    No worries, with the Insurance Breakdown we receive from your insurance company we can use those percentages to estimate your fees for each visit, and submit your insurance forms manually. Our office will collect the estimated amount not covered by your plan; this is the portion that you would pay. Any adjustments needed after the insurance payment is received are to be handled as soon as possible. The patient is responsible for any difference between our estimate of insurance coverage, and the amount paid by the insurer