Common Contracts
1 similar Assignment of Benefits Agreement contracts
ASSIGNMENT OF BENEFITS AGREEMENTAssignment of Benefits Agreement • April 30th, 2017
Our office will accept an assignment of benefits from your insurance company with the provisions listed below. It is important to understand, though, that the agreement 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.
