Common Contracts
1 similar Assignment of Benefits Agreement contracts
ASSIGNMENT OF BENEFITS AGREEMENTAssignment of Benefits Agreement • March 8th, 2010
Our office will accept an assignment of benefits from your insurance company with the following provisions. It is important to understand, though, that the contract regarding your dental benefits is between you, your employer, and your insurance company. The obligation you have with our practice is to pay for treatment, regardless of the amount that may or may not be reimbursed by your insurance company. The following provisions identify our policies governing insurance claims.
