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