Government Relations
[ Date ]
SAMPLE LETTER TO SEND TO YOUR REPRESENTATIVE
Contact PDA’ s staff at( 800) 223-0016 or mss @ padental. org, for your representative’ s name and address, or for an electronic copy of the sample letter you can modify.
The Honorable [ Representative’ s Name ] Pennsylvania House of Representatives [ Insert Capitol Address ] Harrisburg, PA 17120
Dear Representative [ Insert Last name ]:
As a dentist living in your district and one of 5,500 members of the Pennsylvania Dental Association( PDA), I am writing to respectfully request that you vote“ yes” on SB 373, legislation that would require insurers to assign benefits( on patient’ s request) to dentists, regardless of whether they participate with the insurer. The Senate voted for SB 373 on January 22 with a vote of 35-15, and it is now in the House Insurance Committee for consideration.
Assignment of benefits legislation would eliminate financial and administrative burdens for both patients and dentists, and ensure timely care. By enacting assignment of benefits legislation, Pennsylvania would join 23 other states in ensuring that benefit plans are treated as purchased products belonging to the patient.
n Some patients cannot see their dentist of choice because some insurance companies do not directly pay the non- participating provider and they cannot afford to pay for services upfront. Dentists who do not require advanced payment may never be paid for services rendered. This insurance practice unfairly inhibits patients from seeking care from their dentist of choice, even though they are paying for a benefit that should be applied to any provider, regardless of whether or not the provider participates with the patient’ s insurance plan.
n Absence of assignment of benefits legislation forces patients to pay upfront for treatment they may not be able to afford. This can be particularly difficult for divorced or separated parents, single parents and low-income families. It would be much easier for a patient to have the ability to assign the dental benefit directly to the provider.
n Parents who are divorced or separated may experience the problem where one parent has custody of a child while the other parent carries the insurance. The latter may never send the insurance check to the custodial parent, who had to pay for services upfront. Faced with this situation, many custodial parents postpone or avoid care altogether. This could also impact the dentist, who sympathizes with the parent and sees the child without requiring advanced payment. Often these dentists are never paid.
n Patients residing in rural areas are placed at a disadvantage as there may only be a handful of dentists who are in-network. Patients may have to incur more traveling time and expense to seek treatment from an in-network provider, rather than being treated by a non-participating dentist who practices in closer proximity.
A study from the Indiana Health Law Review found that assignment of benefits laws do little, if anything, to increase health care costs. It eliminates many of the administrative hassles associated with billing and payment experienced by both providers and patients, and can even reduce the need for providers to raise rates.
Insurance companies oppose assignment of benefits laws because they feel this will weaken the participant network. Empirical evidence does not substantiate the claim that provider networks are weakened in states with assignment of benefits laws. Most recently, a study from Florida after it enacted assignment of benefits legislation found no net loss in physicians’ participation in network plans.
I thank you for your attention to this important issue that helps providers level the playing field with insurers and better protect patients seeking care from their dentist of choice. Please contact me if you have any questions or concerns at [ Insert contact information ].
Sincerely, Sign Name
MARCH / APRIL 2018 | PENNSYLVANIA DENTAL JOURNAL 11