Assignment of Benefits, defined strictly, is when the insurance subscriber allows his or her dental benefits to be paid directly to the dentist.  The advantage for the patient is that he or she would only be required to pay that part of the bill that is not covered by insurance.  Therefore, the patient would not have to pay a large sum of money and wait for reimbursement from the insurance carrier.  The advantage for the dentist is that the patient will be more likely to agree to a more complete and sophisticated treatment plan with financial obstacles being less of a deterrent.  The disadvantage for the dentist is that there will be a wait for payment from the insurance carrier instead of receiving payment as the procedures are performed.

The simplest way to collect payment is to require the patient to pay for whatever treatment was accomplished on a particular day.  If the patient pays, the balance would then be zero.  If the patient does not pay, or pays only partially, there is a balance and that balance begins to be aged.

When we accept Assignment of Benefits and do not require patients to pay as treatment is completed, we introduce a complication into our bookkeeping.  Different dental offices have different methods of collecting the Patient Portion of charges.  With Diamond Dental Software, we recognize this situation and offer methods to manage what could be a complicated collection problem.

When opening a new account with dental insurance, the Track Patient Portion question is asked. You can see this on the Account Entry screen abbreviated as Track Pt Portion.  This is essentially a question about Assignment of Benefits. The Track Patient Portion question is not asked if the patient does not have insurance.  To answer this question you may select Yes or No.  In answering this question, you are telling the computer to react to posting in a particular way.  The effect this has on posting will now be discussed.

Track Patient Portion - NO
When this question is answered No, the two amounts, Total Balance and Amount Due Now are always kept equal.  The Amount Due Now represents the amount of payment you are expecting from the patient now.  With Track Patient Portion answered No, the Total Balance for that account is always due immediately, as far as the computer is concerned.  Charges start aging at the time of posting.  When the computer looks for charges to age, it looks at the Amount Due Now.  Since the Due Now amount (as well as the Total Balance) increases with every posted procedure, aging is always underway.

When Track Patient Portion is answered No, there is actually no reason to have two balances, because the Due Now amount and the Total Balance are always equal.  In this mode, charges, payments, and adjustments affect the Total Balance and Due Now amounts equally. This is not necessarily the case with Track Patient Portion Yes.

It is permissible to accept assignment of benefits and answer No to the Track Patient Portion question.  In that case, insurance benefits will be mailed directly to the dentist.  The patient can be informed that he or she is only required to pay the "patient portion" of the charges, but this is up to the individual office.