When a patient's record indicates "Assign Benefits to Patient," it is assumed either of these situations:
- The patient will submit the claim.
- The office will create a claim as a courtesy for the patient but will not receive payment from the insurance company.
For these reasons when "Assign Benefits to Patient" is selected there will be no billing dentist information printed on the claim.
A review of the ADA claim form guidelines in the CDT: Dental Procedures code book (any year), the ADA specifies (the highlight is from the ADA’s CDT directions, not Denticon’s emphasis):
The 'Billing Dentist' or 'Dental Entity' section provides information on the individual dentist's name, the name of the practitioner providing care within the scope of their state licensure, or the name of the group practice/corporation that is responsible for billing and other pertinent information. Depending on the business relationship of the practice and the treating dentist, the information provided in this section may not be the treating dentist. If the patient is submitting the claim directly, do not complete Items 48-52A.
The ADA CDT code book, and its accompanying book "Dental Coding Made Simple," are great resources for the ADA's guidelines regarding procedures and claims.
Denticon encourages every office to have a copy of each for reference.