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Tel 800.362.0700 fax 610.965.6962 www.penntreaty.comASSIGNMENT OF BENEFITS Policyholder Name Policy # I, (print Policyholders name), authorize and request Penn Treaty Network America Insurance Company
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What is assignment of benefits?
Assignment of benefits is a legal document that allows a third party to receive payments directly from an insurance company for services provided to the insured individual.
Who is required to file assignment of benefits?
The healthcare provider or service provider is typically required to file assignment of benefits in order to receive direct payment from the insurance company.
How to fill out assignment of benefits?
Assignment of benefits can be filled out by including the insured individual's information, the healthcare provider's information, and details of the services provided. It must be signed by the insured individual.
What is the purpose of assignment of benefits?
The purpose of assignment of benefits is to streamline the payment process by allowing the healthcare provider to receive direct payment from the insurance company.
What information must be reported on assignment of benefits?
The assignment of benefits must include the insured individual's name, policy number, healthcare provider's name, services provided, and the amount to be paid by the insurance company.
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