AOB in full is assignment of benefits. It is the situation where a patient asks that their health benefit be given to them so that they can give it to the doctor. This is mostly so that they can reduce the debt owed to the doctor. This therefore means that the insurance will make payments directly to the person named by the patient in the AOB request form.
How to make an AOB request If you want to make an AOB request you will need to fill out a form. The form should be duly signed by the patient and the doctor. The patient allows the insurance to pay their benefits directly to the doctor named in the form.
Who can get an AOB? Not every patient has the right to an AOB. If they are not, they will not be able to get their benefits transferred even after they have signed a form. The insurance company in this case, will only make the payments if the state mandates that it does. The AOB can be paid on a claim after claim basis. If the patient has no contractual right to send his benefits to another person, and the state mandates that they receive the benefits, the insurance provider will send the benefits to the patient and they can then be billed by the doctor or hospital.
What if the provider does not accept AOB? Some health providers do not accept assignment of benefits. If that is the case, then the payment of the health benefits is sent to the patient or the insurance member. Which services mostly allow for AOB? There are certain services which will always allow for an AOB. These services include; clinical diagnostic laboratory services, ambulance services, drugs and biological services, physician services, physician assistant services for instance nurse and social services.
How does AOB work? After the patient and the doctor agree on the AOB it means something for both parties. For the patient it means that the patient has agreed for the insurance to pay the doctor his/her benefits as stipulated in the coverage determined by the insurance. For the provider it means that they agree to accept the allowable that the insurance provides to the claim as paid in full. This means that the insurance will not bill the patient more than his co-pay or deductible amount. Some insurance companies allow the provider to bill 15% more on the allowable. The provider can appeal or request for a review if they do not agree with the amount approved by the insurance but the patient will not be billed for the difference between the allowed and the billed amount.