What is the "Assign Benefits to Patient" feature?
"Assign Benefits to Patient" is a feature that allows offices to have patient whose insurance information is on file while also only using the Est Pat column. This communicates to your team that the patient's insurance will not be in-network and/or that the patient is expected to pay the full amount of their procedures. In short, Denticon allows the following workflow:
How do I mark an account with "Assign Benefits to Patient"?
- Select Patient [dropdown menu] > Patient Information [option] or from the Patient Overview, press Edit [top-center button]
- Place a checkmark in the "Assign Benefits to Patient" box.
- Click the Save [button] to confirm the selection.
NOTE: The Billing Provider area will be blank (Box 37 + 48) and the Treating Provider (Box 53) will be the only provider information on the claim. This behavior for "Assign Benefits to Patient" cannot be edited and can only be reversed by unmarking the patient for "Assign Benefits to Patient". See this article for details: My claim has no Billing Provider entry. How can I resolve this?
As a result, the patient will be fully responsible for all charges and an insurance claim form can be generated as a courtesy service. All payments made for treatment will be recorded as patient-received payments in the Transactions/Transaction Entry screen, on the Payments/Adjustments tab.
The generated insurance claim will automatically be marked as “Closed” because the office does not anticipate receiving the insurance reimbursement payment. The Closed claim will not appear on Reports/Outstanding Claims reports since the office does not expect to receive the insurance reimbursement payment.
How does this feature relate to claims?
As the “Assign Benefits to Patient” relates to insurance claims:
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When a patient does NOT have "Assign Benefits to Patient" active (NOT checked):
- For e-claims: the insurance claim will appear on the "Batch Claims Processing" screen in the Outstanding E-Claims section
- For paper/printed claims: the insurance claim will appear on the "Batch Claims Processing" screen in the Outstanding Paper Claims section
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When a patient does have "Assign Benefits to Patient" active (checked):
- For e-claims: the insurance claim will appear on the "Batch Claims Processing" screen in the Outstanding E-Claims section
- For paper/printed claims: the claim does not appear on the "Batch Claims Processing" screen
The "Batch Claims Processing" screen's "Paper/Printed" claims section is intended for the office to generate claims for patients which do not have "Assign Benefits to Patient" within the Patient Information screen. This is because the office does need to generate a claim for the patient in order for the patient to receive the insurance reimbursement.
If the patient has “Assign Benefits to Patient” and the insurance carrier indicates “paper claim,” the office should immediately generate a single insurance claim for the patient to sign and mail. Due to the immediate action for a generated claim, the batch claims processing screen will not generate a claim in the paper-claim section.