Assignment of Benefits Laws: Increasing Choice, Removing Burdens for Wisconsin’s Dental Patients

The Wisconsin Dental Association believes that all Badger State residents should have access to quality oral health care, and they should be able to choose the dental provider that’s best for them. To preserve patient choice,  Assembly Bill 62 and Senate Bill 63 would require all dental insurance carriers to permit a covered person to direct that reimbursable benefits for covered services be paid directly to the treating dentist of their choice. Twenty-three states have already passed similar “Assignment of Benefits” laws – this legislation has national, bipartisan momentum.

The problem

When a patient seeing a dentist of their choice wants insurance payments for covered services to go directly to the dentist (known as “assignment of benefits”), Wisconsin law allows insurance providers to ignore the patient’s wishes and refuse to directly issue payment to the provider. Not allowing assignment of benefits has two negative effects on the patient:

  1. The patient may have to pay out of pocket at the time of treatment and await reimbursement, creating financial hardship for some families, particularly in these times of inflation and an uncertain economy.
  2. The dentist will have to contact the patient for payment after services have been rendered, which is often confusing to patients who expect their insurers to pay providers directly.

The solution

AB 62 and SB 63 would allow patients to choose to have insurance payments sent directly to their provider. Insurance companies would pay providers no more than they would if they paid the patient directly – and often would save money if they aren’t required to issue a paper check.

Why an Assignment of Benefits law makes sense for Wisconsin

  • Puts patients in control of their benefits while ensuring that the insurance benefit is used for its intended purpose.
  • Alleviates financial and administrative burdens for patients by allowing payment to be sent directly to the dental office, instead of having the patient pay upfront for services and then await reimbursement from the insurance company.
  • Increases patient choice by allowing them a.) the option to choose to assign their dental benefits directly to the dentist and b.) the option to choose the dental provider that best serves their needs.
  • Reduces cost of care associated with collecting debts and managing losses from non-payments for dentists billing patients.
  • Does not change the amount of reimbursement insurance carriers pay – they pay no more than they would if they pay the patient directly.

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